When the immune system is attacked by pathogens, the body reacts to the infection through inflammation. But, when the inflammation is chronic, it can damage the cells within the body leading to sepsis or blood poisoning. Sepsis can easily put the elderly at risk. The challenge is in noticing the early signs of sepsis in elderly, say doctors.
“The pathogens (bacteria or fungi or virus) are known to silently invade the already-infected body and attack the immune system,” says Dr Farah Ingale, Director-Internal Medicine, Fortis Hiranandani Hospital, Vashi, Mumbai.
Sepsis in elderly: What you must know
“This silent killer can take anywhere between one to eight days to defeat the body’s immune system. Failure to diagnose sepsis in its early stages leads to severe sepsis and eventually, septic shock,” says Dr Ingale.
Studies indicate that septic shock is dangerous as it can cause hypoperfusion (alarmingly reduced blood flow in the organs) and loss of bodily compensatory mechanisms.
Sepsis: The population at risk
People above 65 years of age are more at risk of sepsis or blood poisoning, says Dr TR Hemakumar, Consultant – Internal Medicine, Sakra World Hospital, Bengaluru. The reason could be a decrease in immunity due to age (otherwise known as immunosenescence).
In 2020, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) identified that globally, in the year 2017, 48.9 million incident cases of sepsis were recorded.
Dr Ingale recalls the case of a 76-year-old man who lived with his son and daughter-in-law in Vashi, Mumbai. “The man had sudden breathlessness, chills and high fever. He refused to visit the hospital and thought he would get cured in a couple of days without any intervention. But the family was concerned about his low urine output and finally took him to the hospital,” said Dr Ingale. The doctors found his pulse rate, sugar and blood pressure was alarmingly high. “He also had difficulty breathing. His medical history revealed a renal surgery a few months prior. He developed sepsis due to fungal infection,” said Dr Ingale.
Identify the early signs of sepsis
Dr Hemakumar outlines the early signs for sepsis:
- Fever with chills
- Change in mental status and blood pressure (BP)
- Reduced urination
- Respiratory infection
- Urinary Tract Infection (UTI)
Severe vomiting or diarrhea, seizures, sweaty skin and palpitations are other obvious signs of sepsis, adds Dr Ingale. A 2020 study demonstrated that diarrheal diseases are the most common cause of sepsis.
What other health conditions lead to sepsis
“Diabetes and immunosuppressive conditions such as cancer, HIV, recent surgeries, chemotherapy increases the risk of sepsis in the elderly,” explains Dr Hemakumar. Besides, the use of catheters, tubes, lines, or porters for blood, medicines or food injections increase chances of sepsis and recurrent hospitalisation, Dr Ingale.
Sepsis is curable
Dr Ingale mentions that sepsis is a curable infection and what matters is the early diagnosis. “The treatment is largely determined by the type of pathogen and comorbid medical conditions,” says Dr Hemakumar pointing out that admission in multi-disciplinary ICU, appropriate antimicrobial therapy and organ protective measures can help treat sepsis cases.
Caretakers of elderly must be cautious of the early signs of sepsis, say doctors. Here is what to follow:
- Monitor the elderly closely and check for signs of headache, confusion, abdominal pain or breathlessness.
- Do not ignore any change in their every day activities.
- Low urine output is one of the earliest signs of sepsis.
- Treat infection early to avoid damage to lungs, kidney and other organs.
- Don’t miss their regular check-ups.
Takeaways
- Sepsis or blood poisoning is caused by invading pathogens that damage the cells.
- Elderly people are at high risk of developing sepsis.
- Headache, confusion, abdominal pain, reduced urine output or breathlessness are the early signs.
- Early diagnosis is the best way to cure sepsis. Caretakers of the elderly are advised to look out for the early signs of sepsis.
