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Critical care for sepsis limited in Korea despite high mortality
  • By Kwak Sung-sun
  • Published 2017.12.15 15:39
  • Updated 2017.12.15 15:39
  • comments 0

As patients with sepsis have a high chance of death at upper 30 percent levels and the disease kills 15,000 Koreans every year, the government should expand the support for critical care for sepsis patients, an expert said Friday.

Lim Chae-man, president of Korean Society of Critical Care Medicine (KSCCM), said at a forum at the National Assembly that Korea’s sepsis mortality rate was excessively high. According to Lim, the incidence of sepsis in Korea was 37,897 in 2009, 38,793 in 2010, 36,547 in 2011, 38,988 in 2012, and 33,518 in 2013. The incidence of sepsis is similar to that of tuberculosis in Korea.

However, the number of deaths from sepsis was 14,767 in 2009 (mortality rate 38.9 percent), 15,323 in 2010 (39.6 percent), 14,368 in 2011 (39.3 percent), 15,076 in 2012 (38.7 percent), and 12,665 in 2013 (37.8 percent). The numbers are much higher than the deaths from TB (2,200-2,300 per year) and TB’s mortality rate (6-6.6 percent).

Pointing out the numbers, Lim said the government could reduce sepsis mortality rate if they support professional critical care at hospitals. He urged the authorities to start “sepsis registration project” and help hospitals employee more medical workers for sepsis care in intensive care units (ICUs).

Rep. Park In-sook of the opposition Bareun Party held a debate forum on “the status of sepsis in Korea and measures to tackle it,” at the National Assembly Friday.

“From 2009 to 2011, patients who did not receive a specialist’s medical care had a 42 percent mortality rate. But those who did had an 18 percent mortality rate. Annually, 7,000-8,000 deaths from sepsis would have been preventable,” Lim said.

“Which hospital the patient visits decides his or her mortality rate. The medical care system is to blame for most of the deaths from sepsis. In a country where patients with mild cases get specialists’ care, why can’t sepsis patients receive critical care?” Lim asked.

Suh Gee-young, vice president of KSCCM, emphasized that Korea needs to place different grades on ICUs and establish a medical service delivery system.

“When we have a shortage of ICU specialists, it is not realistic to allocate human resources and equipment similar to the level of advanced nations. The KSCCM should urge the government to put grades on ICUs, overhaul the criteria for facility, equipment, and workforce, and come up with proper reimbursements to reflect the reality,” Suh said.

The Ministry of Health and Welfare said the government would accept the KSCCM’s opinions, reference recommendations from the World Health Organization (WHO), and find solutions to address the sepsis issue.

“Sepsis is a difficult disease to tackle, and an important one. Last year, the WHO released recommendations for sepsis, which include enhancing medical institutions’ infection management, managing drug resistance of anti-biotics, establishing guidelines for treatment, and reinforcing physicians’ capability,” said Kang Min-kyu, director of the ministry’s disease control policy division. “As the WHO recommendation is technically binding, we will make policies based on it.”

Kang added that he mostly agreed with the KSCCM’s calls for building sepsis-related data, hiring more specialists in ICUs, and setting up a particular division within the ministry to manage sepsis.

“We have failed to make sepsis a major agenda item because the complex disease was managed by the ministry’s various divisions, including public healthcare, insurance, and disease control. We will do our best to make it a major agendum as soon as possible,” Kang said.

kss@docdocdoc.co.kr

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