New blood test for sepsis could save lives and money

Sepsis is a life-threatening medical emergency that occurs when an infection can cause a chain reaction throughout the body, causing sequential failure of multiple organs. According to the Centers for Disease Control and Prevention, approximately 350,000 people die each year in the United States from sepsis, making proper diagnosis a matter of life or death.

Patients at high risk for sepsis – typically older adults and people with chronic health conditions, such as kidney disease or cancer. Once you are taken to the hospital through the emergency department, your doctor will test you for sepsis. There is no test that can definitively diagnose sepsis, so doctors use judgment to identify the combination of infection and inflammation associated with sepsis.

A new blood test for sepsis could save lives and money, an interdisciplinary study led by Christopher Hollenbeek, professor of health policy and management in Penn State’s College of Health and Human Development, has found. Result is, Quest for first aid.

The IntelliSep test characterizes changes in a patient’s white blood cells to quickly assess whether a patient is at high risk for sepsis. Hollenbeak, a health economist, and his team modeled the economics of using his IntelliSep test in hospital emergency departments.

“One of the tools health economists use frequently is decision modeling,” Hollenbeek says. “Decision modeling uses mathematical models to calculate the likely outcomes and costs of a particular decision. In this case, for a patient with suspected sepsis, he says, the costs and benefits of using the IntelliSep test. evaluated.”

Hollenbeak explained that decision modeling has no value judgments associated with it.

We provide easy-to-understand information such as “This is how much it will cost to implement your innovation” and “This is the expected outcome for your investment.” Physicians, health systems, and other stakeholders will then be able to use our analysis to decide what to incorporate into the care they provide. In the case of this sepsis test, its use could potentially save lives. ”

Christopher Hollenbeek, Professor of Health Policy and Management, Penn State College of Health and Human Development

Cytovale developed and tested IntelliSep. They then contacted his Hollenbeak to perform decision modeling with IntelliSep to understand the costs and benefits of testing. Hollenbeek said analyzes like this study are common in health economics. A time for medical innovation. Treatments, drugs, or tests – should be evaluated if created; Even though medical tests show this innovation to be safe and effective, questions remain about whether it provides sufficient health benefits compared to the cost for widespread use.

Health economists take available data about innovations and combine them with other data about health care situations to investigate situations where there is uncertainty about the overall benefits of innovations. This allows health economists to examine how different pieces of information differ. – such as cost and effectiveness; may influence whether healthcare providers should take advantage of this innovation.

For this analysis, researchers used data from a trial of the IntelliSep test conducted at Louisiana State University Health Sciences Center in Baton Rouge. They compared these data with data on another available test that can be used to indicate sepsis: measuring a patient’s procalcitonin levels. The researchers said they used the procalcitonin test as a comparison because it is the best widely available test for sepsis.

Procalcitonin is a biomarker released by the body in response to infection. It can be measured with a simple blood test. Although studies have shown that procalcitonin levels can help diagnose sepsis, procalcitonin only indicates the presence of infection and not the inflammation associated with sepsis. The research team noted that procalcitonin testing is not included in current clinical guidelines and that healthcare professionals have never widely supported the use of procalcitonin testing over the use of judgment.

The results of this study showed that IntelliSep performed better than the procalcitonin test. Using the IntelliSep test, he said more than 95% of patients could survive at a treatment cost of less than $4,000 per patient. This had a slightly higher survival rate and lower cost than testing procalcitonin levels.

Most of the cost savings are due to more people being correctly diagnosed with sepsis, Hollenbeak said. Patients with undiagnosed sepsis can be very expensive to treat and have a significantly higher risk of death.

“For sepsis patients, going home from the hospital is very serious because they can go into multiple organ failure within hours,” Hollenbeek said. “Each year, a limited number of patients present in hospital emergency departments and are sent home with symptoms of sepsis. This test could potentially save the lives of many of these people.”

Hollenbeek stressed that testing cannot replace quality clinical care. Instead, this test serves as a diagnostic tool for clinicians.

“It’s a serious decision to admit someone to the hospital,” Hollenbeek said. “It inconveniences patients and costs a lot of money. In medicine, every doctor has to make decisions in the face of uncertainty, so we always need the best information possible. Emergency departments If doctors could get information quickly about how someone could be infected, because he has sepsis, that would be very helpful to them.”

Daniel Henning of the Department of Emergency Medicine at the University of Washington in Seattle, Washington. Glenn K. Zieting, Grant Memorial Hospital Emergency Department, Petersburg, West Virginia; Nathan A. Redebore, Department of Clinical Microbiology and Molecular Diagnostics, Medical College of Wisconsin, Milwaukee, Wisconsin; Imran A. Faruqui, Department of Clinical Medicine, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana; Christy G. Pierce of Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana; Christopher B. Thomas, Department of Clinical Medicine, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana; Hollis R. ‘Bud’ O’Neal Jr., Department of Clinical Medicine, Louisiana State University Health Sciences Center, Baton Rouge, all contributed to this study.

Cytovale, the maker of the IntelliSep test, funded the study. The company had no role in the design or conduct of the study or in the interpretation of results. This study was published following independent peer review.