Looking at Sepsis in Patients with Terminal Illnesses

Opinion statementSepsis is a serious and common condition among hospitalized patients, and, for those with terminal illnesses, mortality from sepsis remains high. Early palliative care consultation reduces symptom burden, improves caregiver experience, and facilitates discussions regarding goals of care. Despite these benefits, palliative care remains an underutilized resource for patients with serious illnesses. This review proposes how infectious disease physicians can help identify patients requiring palliative care consultation and provide valuable input during these discussions. Prior studies demonstrate that early identification of patients requiring ICU admission can improve patient mortality. Additionally, there is conflicting data on the use of antibiotics in terminally ill patients with sepsis. The decision to continue these care measures requires prompt discussions with patients and their families with a qualified palliative care team. Although it is difficult to rapidly identify all patients with sepsis that require a palliative care consult, research has shown that mortality scoring systems, such as APACHE II and SOFA, can assist with determining mortality risk in this subset of patients. The infectious disease physician is uniquely positioned to engage palliative care consultation early, given their proximity to patients with sepsis and knowledge of the disease course. Working with the palliative care team, infectious disease specialists can help make comple...
Source: Current Treatment Options in Infectious Diseases - Category: Infectious Diseases Source Type: research