Sepsis & Chronic Illness: Why People With Diabetes, Cancer, & Other Conditions Are At Higher Risk

Sepsis, a syndrome of microbial infection complicated by a systemic inflammatory response, can become a life-threatening medical emergency. The ailment generally arises when the body’s response to infection causes widespread inflammation, leading to tissue damage or organ failure, leading to potential risks of death. While anyone can develop a serious medical condition, those suffering from chronic illnesses like diabetes, cancer, kidney disease, or lung disease remain at higher risk of developing sepsis. 

Sepsis and chronic conditions have a bidirectional and complex relationship, which can lead to a cycle where worsening chronic illness can escalate the risk of infection, which can then lead to severe conditions.

Chronic Illnesses and Higher Risk for Sepsis

The body’s immunity power often gets weakened by Immunosuppression and Compromised Health Chronic illnesses, making it harder for individuals to ward off infections. For instance, People suffering from cancer, undergoing certain treatments, like chemotherapy, who have compromised immune systems and are at increased risk of sepsis infection. Chemotherapy, a very common treatment of cancer, kills the fastest-growing cells in the body, both good and bad, and some types also kill infection-fighting white blood cells, putting the patient or their loved ones at higher risk.

Additionally, cancer patients, especially those with metastatic disease, are at risk due to invasive treatments and weakened immunity power. According to studies, people suffering from cancer coupled with sepsis have a high in-hospital mortality rate—around 38.4 per cent, making sepsis a major risk for those with compromised immune systems due to their underlying disease.

Similarly, another life-threatening disease diabetes adversely affects the body’s normal immune functions, damaging the body’s ability to safeguard itself from infections. Diabetic patients are susceptible to complications like acute renal failure and respiratory issues when they develop sepsis, making infection control more challenging. Also, chronic conditions like diabetes increase the risk of frequent infections, leading to sepsis if not treated timely. High blood sugar levels create an ideal environment for bacterial growth, causing skin, urinary tract, and respiratory infections. Proper management can prevent these infections from escalating into sepsis.

Chronic kidney disease (CKD) or liver cirrhosis can significantly weaken bodily functions that impair waste filtration and detoxication, putting patients at higher risk of sepsis. This increases the likelihood of bacterial or viral infections progressing into sepsis.

The systemic impact of chronic conditions can gradually result in systemic impacts that can make sepsis outcomes worse. Delayed recognition and diagnosis can be a major factor that increases the risk of the delayed recognition of sepsis symptoms. Studies have brought forward that several patients, especially those with chronic illnesses, fail to recognise sepsis as a medical emergency in the initial stages. Some of the common symptoms of sepsis may include changes in mental status, fast, shallow breathing, sweating for no clear reason, feeling lightheaded, and shivering. These symptoms may often be mistaken for exacerbations of the underlying chronic condition, leading to delay in treatment.

Recent Data

While there is not much awareness of sepsis among the common populous, sepsis still remains one of the most critical global health challenges. Data from the Mckinsey & Company indicates that nearly 79 per cent of all deaths worldwide were caused due to people suffering from chronic diseases like cardiovascular disease, cancer, diabetes, and respiratory diseases. Also, respiratory ailments have been found responsible for 79 per cent of deaths worldwide and the trend is expected to reach 84 per cent by 2030. These alarming numbers also suggest that the rising risk of sepsis-related complications will continue to grow further. Despite advancements in medical treatment, the incidence of sepsis has been at a steady rise. 

Protect Yourself and Loved Ones 

Given the heightened vulnerability of people with chronic illnesses to sepsis, people with chronic illness being more susceptible to sepsis, certain proactive and timely measures can keep you and your loved ones safeguarded: 

1. Timely Medical Care 

Individuals with chronic illnesses should always remain vigilant and undergo routine check-ups and health monitoring from medical experts. Getting regular follow-ups can ensure that any building infection or complication in the body gets diagnosed at an early stage and treated before its too late.

For example, it is always suggestible for diabetic patients to monitor their blood sugar levels closely and seek immediate medical attention for any signs of infection, such as fever, pain, or redness around a wound. 

2. Vaccinations 

Unlike chronic diseases, certain infections that can lead to sepsis, like pneumonia, the flu, or meningitis, are preventable with vaccines. To reduce the risk of infection, annual flu shots and other recommended vaccines are critical in reducing the incidence of infections, thereby lowering the chances of developing sepsis.

3. Prompt Treatment

Individuals suffering from chronic conditions must immediately seek medical help to treat infections, even minor ones. If left untreated, even the simplest wounds can become septic, resulting in serious medical conditions. If a patient witnesses any symptoms of infection like fever, chills, pain, or unusual discharge from a wound, they should take prompt measures and contact a healthcare professional at the earliest. 

4. Hygiene

A strict hygiene and balanced diet can be a natural solution to several diseases, and it can also be effective in preventing infections. It is always suggestible to take preventive measures like regular handwashing, proper wound care, and maintaining the cleanliness of medical devices such as catheters to remain healthy and grow the immunity power to fight diseases. Maintaining cleanliness is especially vital for people with chronic conditions as even minor infections skin infections or UTIs can quickly become severe. 

5. Recognising Early Signs

Early detection of sepsis is crucial for survival. The mnemonic "TIME" helps identify symptoms such as temperature, infection, mental decline, and extreme illness. If these signs are present, especially in individuals with chronic illnesses, should seek immediate medical attention, especially if the person is experiencing extreme pain or confusion.

6. Maintaining Hospital Safety

Hospitals are common sites for infection, especially for patients whose immunity is significantly compromised. Such patients should always ensure that healthcare professionals practice proper hygiene, like wearing gloves and sterilising equipment. Also, the caregivers should not hesitate to ask healthcare workers about infection control measures during hospital stays. 

Role of Technology in Managing Chronic Conditions and Sepsis Risk 

Technological advancements in medical science, especially digital therapeutics, provide promising solutions for managing chronic conditions and mitigating the risk of sepsis. Digital health platforms can monitor vital signs in real time and help detect early signs of infection, potentially preventing sepsis. The integration of connected medical devices allows for better management of chronic diseases, ensuring infections are diagnosed at an early stage.

Awareness and understanding are crucial for individuals with chronic illnesses, to improve health outcomes. By taking preventative measures, ranging from routine check-ups and vaccinations to hygiene practices and real-time health monitoring, individuals can significantly reduce potential risks. With the global rise of chronic disease, the need for targeted education and interventions to address sepsis is more important now. Recognising the early signs of infection and sepsis, and acting swiftly, can save lives.

The author is Critical Care specialist, CK Birla Hospital, CMRI

Dr. Anirban Chattopadhyay

Guest Author Critical Care specialist, CK Birla Hospital, CMRI