Australian researchers are calling for a global review of sepsis guidelines, after a survey found one in eight patients with infections requiring intensive care did not meet current criteria.

Researchers from Monash University and the Australian and New Zealand Intensive Care Society (ANZICS) reviewed data collected on over a million patients admitted to 172 Intensive Care Units (ICU).

From the data, 109,663 patients with infection and organ failure were identified with possible sepsis, but despite these symptoms, more than 13,000 patients from this group did not meet the classic criteria used to diagnose sepsis.

It appears that doctors around the world are using the same criteria to identify and categorise patients who are critically ill due to sepsis.

“To be diagnosed with sepsis, a patient must be thought to have an infection and exhibit at least two of the following criteria: abnormal body temperature or white blood cell count, high heart rate, high respiratory rate or low carbon dioxide level in the blood,” researcher Dr Maija Kaukonen said.

“But our study found that many patients, for example the elderly or those on medications that affect heart rate or the immune system, may not meet the classic criteria to diagnose sepsis, despite having severe infections and organ failure. If we continue to use these criteria we may miss the opportunity to identify many critically ill patients with sepsis.”

Fellow researcher Professor Rinaldo Bellomo said that while the classic definition of sepsis has been widely used throughout the world, after 20 years it is time for a review.

“There are clear signs from this study, that if we continue to use these criteria, we may fail to identify septic patients and therefore potentially delay their treatment,” he said.

The study is published in the New England Journal of Medicine.