TY - JOUR T1 - Is ‘sepsis’ a failed paradigm? JF - Emergency Medicine Journal JO - Emerg Med J SP - 270 LP - 271 DO - 10.1136/emermed-2021-211627 VL - 39 IS - 4 AU - Adrian A Boyle Y1 - 2022/04/01 UR - http://emj.bmj.com/content/39/4/270.abstract N2 - 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 … ER -