Stages of Sepsis
- Reviewed By
Anthony C. Lanzone, Founding Partner
- Sepsis progresses through three increasingly dangerous stages: sepsis, severe sepsis, and septic shock with septic shock being the most advanced and serious stage.
- The stages of sepsis can progress rapidly and may result in death in as little as 12 hours. However, the exact timeline looks different for everyone, depending on their age, overall health, and the underlying infection.
- Nursing home residents tend to have reduced immune function and chronic health conditions, which increase the risk of sepsis in nursing homes. However, most cases can be prevented with proper infection control and quality care.
Table of Contents:
- What Is Sepsis?
- The Three Stages Of Sepsis
- How Long Does Sepsis Last?
- How Long Does It Take for Sepsis To Be Fatal?
- What Is The Long-Term Impact Of Surviving Sepsis?
- Preventing Sepsis In Nursing Homes
- Can I Sue a Nursing Home for Sepsis?
- Hold the Nursing Home Accountable for Your Loved One Developing Sepsis
What Is Sepsis?
Sepsis is the immune system’s overreaction to an infection. While any infection can lead to sepsis, it typically starts as a bacterial infection in the lungs, urinary tract, skin, or gastrointestinal tract.
When sepsis sets in, blood pressure drops, and the body loses its ability to provide adequate blood flow to the tissues and organs. It is a medical emergency that requires aggressive treatment. As the condition progresses through the three stages, vital organs become damaged and lose function.
The Three Stages Of Sepsis
Sepsis sets off a chain reaction that begins with an infection and ends in organ failure or death without immediate intervention.
Stage 1 | Stage 2 | Stage 3 | |
Name | Sepsis | Severe Sepsis | Septic Shock |
Body’s Response | Systemic inflammatory response to an infection. | The infection begins to cause organ dysfunction and damage. | Critical drop in blood pressure, leading to profound oxygen deprivation in tissues and organs. |
Signs | Fever of 100.4°F; Heart rate of 90 beats per minute or higher; Breath rate higher than 20 breaths per minute | Decreased urine output; Confusion; Shortness of breath; Abdominal pain | Very low blood pressure; Cold limbs; Paleness; Rash |
Risk of Death | Most survivable stage | 25% with severe sepsis die. | 50 to 75% of patients who reach this stage die. |
Stage 1 or Sepsis
The first stage of sepsis is also known as systemic inflammatory response syndrome or SIRS. The immune system produces inflammatory substances known as cytokines. These substances help fight infection, but they can cause the blood vessels to dilate and create small clots in the internal organs. This response leads to a chain reaction in susceptible individuals, with the body essentially attacking itself. In many cases, bacteria enter the bloodstream and spread, a condition known as septicemia.
Stage 1 is the most survivable, but it can quickly progress to the more advanced stages without immediate treatment. The clinical signs of stage 1 sepsis include the following:
- Fever of 100.4°F
- Body temperature lower than 96.8°F
- Heart rate of 90 beats per minute or higher, a condition known as tachycardia
- Breath rate higher than 20 breaths per minute, also known as tachypnea
- Very high or very low white blood count
If your loved one develops sepsis, nursing home staff must detect it at this stage to prevent long-term complications and increase your loved one’s chance of survival.
Stage 2 or Severe Sepsis
If blood vessels remain dilated, sepsis can lead to low blood pressure, or hypotension. Hypotension reduces blood flow to the organs and tissues, resulting in oxygen deprivation. Breathing becomes anaerobic, or non-oxygen-producing, leading to lactic acid build-up. If lactic acid levels become too high, the body’s pH can become too acidic. This is known as lactic acidosis.
The heart pumps less blood, further reducing blood flow to the tissues and organs, leading to organ failure. It can cause nausea, vomiting, fatigue, muscle cramps, and rapid, deep breathing. If you see these symptoms in your loved one, it could indicate severe sepsis.
Your loved one may also experience the following symptoms:
- Decreased urine output
- Confusion, disorientation, or sudden cognitive impairment
- Decreased blood platelets
- Shortness of breath or the need for a respirator
- Abdominal pain
Approximately 25 percent of patients with severe sepsis die. Hypotension is the driving factor behind the progression of sepsis.
Stage 3 or Septic Shock
If IV fluids and medication fail to raise blood pressure, the body enters a state known as distributive shock. Tiny blood vessels known as capillaries leak and lose pressure. The blood vessels dilate further, leaking fluid into surrounding tissues, and the heart fills with increasing amounts of blood, making it harder to pump out.
The heart tries to compensate by beating more rapidly. However, it pumps less and less blood with each beat, severely depriving the vital organs of oxygen and nutrients and leading to multiorgan dysfunction syndrome. As many as 50 to 75 percent of patients who reach this stage die.
Septic shock symptoms include the following:
- Very low blood pressure
- Lightheadedness
- Low urine output
- Heart palpitations
- Cold limbs
- Paleness
- Rash
How Long Does Sepsis Last?
The duration of sepsis depends on how quickly it is detected and treated. In cases where sepsis is identified early and aggressive treatment begins immediately, the acute phase may resolve within 7 to 10 days with appropriate antibiotic therapy and supportive care. However, the recovery timeline varies significantly based on several factors.
For patients who reach severe sepsis or septic shock, recovery times extend considerably, often lasting weeks to months even with intensive medical intervention. Some patients may require prolonged hospitalization in intensive care units (ICUs) and extended antibiotic courses. Additionally, survivors of severe sepsis may experience long-term complications and post-sepsis syndrome that can persist for months or even years after the initial infection resolves.
In nursing homes, where residents often have multiple comorbidities and compromised immune systems, the duration of sepsis may be longer, and the risk of complications increases substantially. Early detection and prompt treatment are essential not only to prevent mortality but also to minimize the duration of the acute illness and reduce the risk of permanent organ damage.
How Long Does It Take for Sepsis To Be Fatal?
According to the Physician-Patient Alliance for Health & Safety, sepsis can develop rapidly and result in death within 12 hours. The exact sepsis timeline varies from one patient to the next depending on the underlying infection, age, and overall health. The most important factor is intervention. According to the Mayo Clinic, survival increases dramatically when early, aggressive treatment begins within hours of onset. This rapid progression is why nursing home staff must monitor residents closely for signs of infection and report any concerning symptoms to medical providers immediately.
Mortality Rate for Sepsis
The overall mortality rate for sepsis is 30 to 40 percent. However, a study published in the International Journal for Equity in Health found that the risk of developing sepsis and dying from it is higher in nursing homes.
What Is The Long-Term Impact Of Surviving Sepsis?
If sepsis is detected and treated early, it may resolve with no long-term complications. However, if it progresses to severe sepsis or septic shock, it can cause permanent damage, known as post-sepsis syndrome. The risk of post-sepsis syndrome increases the more the condition progresses. Symptoms of post-sepsis syndrome include the following:
- Insomnia
- Fatigue
- Shortness of breath
- Disabling pain in the muscles or joints
- Swollen limbs
- Recurring infections
- Weight loss
- Loss of organ function
- Amputation
- Decreased cognitive function
- Hair loss
- Rashes
- Emotional trauma
- Post-traumatic stress disorder
- Depression
- Increased risk of sepsis
Preventing Sepsis In Nursing Homes
Nursing home neglect contributes to the risk of sepsis. Nursing homes can prevent most sepsis cases by doing the following:
- Use proper hand hygiene
- Sterilize instruments
- Isolate residents with contagious infections like MRSA and COVID-19
- Prevent bedsores by repositioning immobile residents often and performing regular skin checks
- Clean wounds and change dressings as prescribed
- Control chronic conditions
- Avoid indwelling catheters
- Report changes in a resident’s condition to the doctor immediately
- Keep resident vaccinations up to date
Sepsis is a medical emergency even in its earliest stage. All nursing staff must know how to detect sepsis in its earliest stage and obtain immediate treatment. A nursing home can be held liable for failing to prevent, detect, or treat sepsis.
Can I Sue a Nursing Home for Sepsis?
Yes, you can sue a nursing home for sepsis injuries if they were caused by negligence. Often, a resident will develop a pressure ulcer (commonly known as a bedsore) because staff failed to properly turn and reposition them. If left untreated, these ulcers can break down the skin into a large, open wound that quickly becomes infected.
Sepsis occurs when an infection goes completely out of control. All nursing staff have a strict duty of care to monitor residents, detect the early warning signs of infection, and obtain immediate medical treatment. When they fail to act, the body begins going into organ failure, which can become fatal in a matter of hours.
Hold the Nursing Home Accountable for Your Loved One Developing Sepsis
If your loved one has suffered from advanced sepsis symptoms such as confusion, shortness of breath, or abdominal pain before being diagnosed with sepsis, the nursing home may have failed to detect it at an early enough stage. The nursing home and staff may be liable for the resulting complications.
At Lanzone Morgan, LLP, we can investigate the nursing home and prove staff failed to prevent sepsis or diagnose it early. You or your loved one may be entitled to substantial compensation through a nursing home neglect lawsuit. We have over 75 years of experience and have recovered over $250 million in compensation. Call 1(888) 887-9777 now or contact us online to schedule your free, no-obligation case review.
- Fact-Checked
This content has been legally reviewed and approved by nursing home abuse attorney, Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.
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- Fact-Checked
This content has been legally reviewed and approved by nursing home abuse attorney, Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.