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Is ‘sepsis’ a failed paradigm?
  1. Adrian A Boyle
  1. Emergency Department, Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Adrian A Boyle, Emergency Department, Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; adrian.boyle{at}addenbrookes.nhs.uk

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In this issue, Sabir et al report a detailed description of a representative series of patients identified as ‘septic’ in their emergency department.1 Many expert bodies have called for a better understanding of the epidemiology of sepsis and the authors are to be commended for this work.

They included patients who had blood cultures taken for presumed sepsis. Their main finding is the substantial burden of chronic disease and co-morbidity that many of these patients were living with before they required emergency department treatment. It is striking that less than half were living at home, and nearly 90% had some important co-morbidity. Furthermore, only 6.5% were referred to intensive care. Few of these patients presented in septic shock. These patients were sick, with a 13.2% in-patient mortality, but it is difficult to escape the conclusion that many were simply at the end of their life. It is possible that ‘sepsis’ has taken over from pneumonia as the ‘old man’s friend’, a term that medicalises death.2 The authors acknowledge the limitations …

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Footnotes

  • Handling editor Ed Benjamin Graham Barnard

  • Twitter @dradrianboyle

  • Contributors AAB was commissioned to write this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; internally peer reviewed.

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