Diagnosing sepsis: a step forward, and possibly a step back

Sepsis/severe sepsis continues to be a worldwide public health problem, ending some lives prematurely, maiming others, and requiring inordinate amounts of healthcare expenditures (1-4). One of the keys to effective treatment of the condition is early recognition and initiation of therapy, and it has long been a goal of physicians in general, and intensivists specifically, to use diagnostic approaches that allow us to predict adverse outcomes, such as death, in patients who are sick but who are not so critically ill that our interventions lack effectiveness.