There isn't one single "highest" sepsis score, as different scoring systems exist (like SOFA, qSOFA, NEWS2, PSS), each with varying maximums, but they generally aim to quantify severity, with higher scores indicating worse outcomes, often signaling high risk for mortality or organ dysfunction, with some models reaching scores like 12 (REDS) or higher thresholds for alerts (e.g., PSS >8). The key is that higher scores on any validated system suggest increased severity, not a fixed top number.
Scores range from 0-4 (low risk), 5-6 (medium risk), and ≥7 (high risk for sepsis-associated mortality).
Septic shock is the most severe stage of sepsis. It is defined as the presence of hypotension, induced by sepsis, despite fluid resuscitation. In addition, perfusion abnormalities such as elevated lactate levels. Septic shock has the highest chance of mortality, with estimates ranging from 30% to 50%.
Some sepsis scoring systems (NEWS, SOFA, qSOFA, and MEDS) require the assessment of mental status, as sepsis-associated encephalopathy is indicative of increased mortality risk. GCS and the AVPU scale are two frequently used scales that assess neurologic status. All patients in this study had GCS assessed at triage.
A high NEWS does not provide a diagnosis; but it helps identify a sick patient who is deteriorating and requires urgent clinical review in a standardised way. The Royal College of Physicians (RCP) recommend that sepsis should be considered in any patient with a NEWS of 5 or more.
Interpret the Score: A low NEWS Score (0-4) indicates that the patient's condition is stable. A moderate NEWS Score (5-6) suggests that the patient may be at risk and requires close monitoring. A high NEWS Score (7 or higher) indicates a significant risk of deterioration, and immediate action is needed.
SIRS, Sepsis, and Septic Shock Criteria
Severe sepsis develops when the infection causes organ damage. Septic shock is the most severe form in which the infection causes low blood pressure, resulting in damage to multiple organs. About three in every 10 patients with severe sepsis, and half of those with septic shock, die in the hospital.
Blood tests may reveal the following signs suggestive of sepsis: Elevated or low white blood cells – Higher than usual levels of leukocytes, known as white blood cells (WBCs), are a sign of a current infection, while too few WBCs indicate that a person is at higher risk of developing one.
Symptoms of sepsis
While acute survival from sepsis has improved dramatically in recent years, a large fraction of sepsis survivors experience poor long-term outcomes. In particular, sepsis survivors have high rates of weakness, cognitive impairment, hospital readmission, and late death.
Bacterial infections are one of the most common causes of sepsis. Fungal, parasitic and viral infections are also potential sepsis causes. You can get sepsis when an infection triggers a chain reaction throughout your body causing organ dysfunction.
The evidence behind the “golden hour” protocol
The main finding was that patients who received antibiotics within the first hour of sepsis recognition had a 79.9% chance of survival. It was also found that with every additional hour, the chance of survival decreased by 7.6%.
Studies show that 40% of patients with the severe stage of sepsis don't survive, and the septic shock mortality rate can be as high as 50%. Survivors of sepsis often have ongoing health issues and are at higher risk of future infections and complications.
Those initially diagnosed with septic shock clinically have a higher risk of death within 28 days. Progression from sepsis to severe sepsis or septic shock within the first week of diagnosis increases the chances of mortality.
However, over the past 25 y it has been shown that gram-positive bacteria are the most common cause of sepsis. Some of the most frequently isolated bacteria in sepsis are Staphylococcus aureus (S. aureus), Streptococcus pyogenes (S. pyogenes), Klebsiella spp., Escherichia coli (E.
A high CRP value of over 300 mg/L may be due to a strong infection or inflammation. With a common cold, CRP is usually not increased at all or only slightly. If you get a strong viral infection such as influenza, the CRP value can be above 50 mg/L.
Many sepsis survivors have said that when they were ill, it was the worst they ever felt. It was the worst sore throat, worst abdominal pain, or they felt that they were going to die. Children developing sepsis may exhibit different symptoms, as seen below.
High CRP levels may mean you have an acute or chronic health condition, such as: Infections from bacteria or viruses. Inflammatory bowel disease, disorders of the intestines that include Crohn's disease and ulcerative colitis. Autoimmune disorders, such as lupus, rheumatoid arthritis, and vasculitis.
Sepsis is now defined as a “life-threatening organ dysfunction caused by a dysregulated host response to infection”. The authors defined organ dysfunction as an increase in the Sequential (Sepsis-related) Organ Failure Assessment (SOFA) score or ≥2, and this was associated with a 10% mortality risk (10).
Results: We found that one-third of the patients diagnosed as sepsis admitted to the intensive care unit, the mean duration of management 15.8 days. Many investigations did for these patients, the treatment which given to the patients was iv.
Most people make a full recovery from sepsis. But it can take time. You might continue to have physical and emotional symptoms. These can last for months, or even years, after you had sepsis.
According to the Physician-Patient Alliance for Health & Safety, sepsis can progress quickly, causing death in as little as 12 hours. Sepsis Alliance states, the risk of death increases by 7.6% for every hour that passes without treatment. Urgent treatment for blood poisoning is essential.
Our study identified an increased risk of sepsis within 90 days of discharge among patients with exposure to high-risk antibiotics or increased quantities of antibiotics during hospitalization.
Based on this pathophysiology, new definition of septic shock can be explained although serum lactate level of 2 mmol/L (18.2 mg/dL) is normal value. Therefore, if a patient has a serum lactate level >2 mmol/L, BP or serum lactate level should be carefully monitored.