01 appendicitis misdiagnosis girls tapper
Jake Tapper shares harrowing story of daughter's near-fatal misdiagnosis
06:21 - Source: CNN
CNN  — 

In a typical year, at least 1.7 million adults in the US develop sepsis, and at least 350,000 die in the hospital or are moved into hospice care, according to the US Centers for Disease Control and Prevention.

On top of that, about a third people who die in a hospital in the US have sepsis during that hospitalization, the agency says.

CDC data shows that many US hospitals do not have the resources to identify sepsis and treat it as early as possible.

On Thursday, CDC Director Dr. Mandy Cohen announced the launch of the agency’s Hospital Sepsis Program Core Elements, a guide to complement and support the implementation of existing sepsis guidelines at US hospitals.

Sepsis is the body’s extreme response to an infection. The life-threatening condition requires urgent medical care to prevent organ damage and death.

In some cases, sepsis or the infections leading up to it are not properly identified because they can come with a wide range of symptoms such as confusion or disorientation, shortness of breath, high heart rate, fever, shivering or feeling very cold, extreme pain or discomfort, and clammy or sweaty skin, the CDC says.

“That’s why CDC developed the Hospital Sepsis Program Core Elements to put providers in the best position possible to deliver effective care for patients with sepsis,” Cohen said.

One of those patients was Alice Tapper, daughter of CNN anchor Jake Tapper, who had a near-fatal misdiagnosis of appendicitis in 2021, at the age of 14.

After going to the hospital with stomach cramping, a fever, chills and vomiting, Alice was told she had a viral infection or gastroenteritis, despite her parents’ concerns about appendicitis.

Days later, when her condition continued to decline, Alice was diagnosed with appendicitis and rushed into surgery. But by then, her appendix had ruptured, and she quickly developed sepsis.

Alice said during the CDC briefing Thursday that although she fully recovered, she is frustrated that her diagnosis was missed.

“If the appendicitis had been taken seriously and the signs and symptoms of sepsis have been acknowledged, my course of care would not have resulted in weeks in the hospital and a long recovery at home,” she said.

More than 75,000 children develop severe sepsis each year. But the risk is higher in people 65 and older, along with those who have a weakened immune system, the CDC says.

“Stories like Alice’s reminded us that even the most knowledgeable, dedicated, committed and experienced teams can be surprised by sepsis,” Dr. Chris DeRienzo, senior vice president and chief physician executive for the American Hospital Association, said Thursday.

But many hospitals don’t have the proper programs in place to rapidly respond to sepsis, according to a 2022 survey of 5,221 US hospitals published Thursday in the CDC’s Morbidity and Mortality Weekly Report.

In fact, the survey found that only 73% reported having a sepsis committee charged with monitoring and reviewing sepsis care and outcomes. These committees were less common in smaller hospitals that had fewer than 25 beds.

The survey, which evaluated the prevalence and characteristics of sepsis programs in acute care hospitals, also found that only 55% of US hospitals had dedicated time for sepsis program leaders to manage the programs.

Meanwhile, 55% of sepsis committees reported the involvement of antibiotic stewardship programs, which monitor and review antibiotic and antifungal use in sepsis care.

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“CDC is calling on all US hospitals to have a sepsis program and raising the bar on sepsis care,” Cohen said.

Hospitals across the country are encouraged to implement parts of the core elements into their operations, but Dr. Raymund Dantes, assistant professor of medicine at the Emory University School of Medicine, told CNN that about 1,400 hospitals are starting from scratch because they do not have a sepsis committee in place.

The new core elements document that the CDC is providing to hospitals will have a “getting started guide” to help implement their own committees.

“For those hospitals that already have sepsis programs underway and have available resources, we have a lot more details and best practices that we’ve collected from hospitals about how to better improve your sepsis programs,” Dantes said.

Most adults with sepsis (87%) go to the hospital with an infection that is not getting better. But there are some steps people can take to help prevent sepsis and its effects, the CDC says. First is getting vaccinated against viruses like the coronavirus, the flu and RSV.

Bacterial infections cause most cases of sepsis, according to the CDC, so prevent infections by cleaning scrapes and wounds and practicing good hygiene, such as regular bathing and hand-washing.

Alice Tapper says everyone needs to keep sepsis in mind when they’re sick because time is of the essence when an infection is getting worse.

“It is a lot more common than people think,” she said. “Recognizing the dangers of the ticking clock, of how short the time span is when you have sepsis, and how bad it can get and how quickly it can get bad.”

Correction: A previous version of the story misattributed information about hospital programs to respond to sepsis. It should have cited the CDC MMWR.