NASCAR star’s death shows how sepsis can kill anyone if not caught

Kyle Busch won more races than any driver in NASCAR history.

But his own race ended far too soon, cut short by a condition called sepsis at the age of 41 after a case of pneumonia.

How a seemingly healthy man could die so suddenly, of a condition that many people haven’t heard of, don’t understand, or think only happens in older adults, sent shock waves through the auto racing community and beyond. 

But even as Busch’s family, friends, teammates, competitors and fans mourn him, the loss may perform an important public service: raising awareness of the critical importance of timely sepsis diagnosis and care.

“Moments like this are painful reminders of how quickly serious infections can become life-threatening,” said Stephanie Parks Taylor, M.D., M.S., Chief of the Division of Hospital Medicine at University of Michigan Health and a longtime sepsis researcher and specialist. 

“Pneumonia can progress rapidly, and in some cases, it can trigger sepsis — a medical emergency caused by the body’s overwhelming response to infection. Early recognition and rapid treatment are critical, and they can make the difference between recovery and tragedy.”

Taylor and other U-M experts have worked for years to improve sepsis care in Michigan, nationwide and globally. 

Their main goal: to try to speed diagnosis and improve treatment once a patient seeks care from a clinic, first responder or emergency department. 

But even as they work to boost sepsis response by healthcare providers, that care also relies on better public recognition. 

What are the symptoms of sepsis?

“While every individual’s medical situation is unique, and the specifics of Kyle Busch’s situation aren’t known, this tragic situation underscores the importance of taking symptoms seriously, especially difficulty breathing, persistent fever, confusion, extreme weakness, chest pain, or a sudden worsening of illness,” said Taylor, who is a Professor of Internal Medicine at the U-M Medical School. 

“Awareness of these symptoms is critical because early recognition and timely treatment save lives.”

The Sepsis Alliance recommends memorizing the word TIME for recognizing sepsis: 

• T for a temperature that’s higher or lower than normal,
• I for infection symptoms,
• M for mental decline including confusion or sleepiness, and
• E for extremely ill including pain, discomfort and shortness of breath

What is sepsis and how is it treated?

Sepsis is the body’s overwhelming and potentially life-threatening response to infection. Pneumonia, an infection of the lungs by viruses or bacteria, is one of its most common causes. 

While the term “blood poisoning” used to be used to describe sepsis, it’s not an accurate term. 

Instead, to use a racing metaphor, it’s better to think of sepsis as the body’s immune system going into overdrive, and spinning out of control trying too hard to defeat an infectious invader. 

The wreckage that the immune system’s overreaction leaves behind isn’t tires and bumpers strewn on a track, but rather internal organs shut down by damage. 

That’s why pneumonia and sepsis are both leading causes of hospitalization, critical illness, and death worldwide. 

Each year in the United States, pneumonia is associated with tens of thousands of deaths, while sepsis affects more than a million people and contributes to at least 350,000 adult deaths. 

Worldwide, sepsis is involved in the deaths of about 13 million people a year.

How is sepsis care being improved?

But sepsis doesn’t have to be fatal, as long as it’s diagnosed early enough and treated effectively.

Rapid diagnosis, prompt antibiotics, supportive care in a hospital setting including an intensive care unit if needed, and close monitoring by trained medical professionals can dramatically improve outcomes.

That’s why Taylor and others have called for encouraging people to seek care early, even as they work to strengthen systems for rapid detection and evidence-based treatment.

“All of these are essential steps to reducing preventable deaths and helping patients recover fully after serious infection,” she said.

U-M sepsis research has shown ways to reduce sepsis deaths, and has helped inform the development of a free Sepsis Toolkit that has now been rolled out for use in 68 Michigan hospitals through the Michigan Hospital Medicine Safety Consortium.

In just the last three years, that toolkit has meant that 350 fewer Michiganders have died from sepsis after reaching a hospital, according to the latest data. 

The HMS Sepsis Initiative is led by U-M critical care physician Hallie Prescrott, M.D., M.Sc., who has led a number of studies aimed at improving sepsis care.

Prescott co-led the writing of the latest version of international sepsis treatment guidelines released this spring. 

"While awareness of the term sepsis has increased in recent years, it still lags behind other time-sensitive medical emergencies like heart attack and stroke," she said. "Many people’s first instinct with worsening symptoms of infection may be to get a good night’s rest. However, symptoms such as confusion or somnolence, lightheadedness, weakness, shortness of breath, and minimal urine can all be signs that infection is progressing to sepsis, and it is important to seek immediate medical care." Prescott is a Professor of Internal Medicine in the Division of Pulmonary and Critical Care Medicine.

The guidelines pay special attention to the care provided in ambulances, because half of sepsis patients arrive at hospitals via ambulance and more screening and care could begin then. 

The guidelines also focus on appropriate use of antibiotics, to avoid overuse that could inadvertently lead to the evolution of dangerous “superbugs” that evade treatment with the most powerful drugs.

Both Prescott and Taylor are members of the U-M Institute for Healthcare Policy and Innovation, which also includes other U-M faculty who are working to improve sepsis care through their own work.

Meanwhile, teams at the U-M Weil Institute for Critical Care Research and Innovation are working on interventions for sepsis detection and care.

Can sepsis be prevented?

When it comes to preventing sepsis, it’s important to think upstream from infections.

Vaccination against flu, COVID-19 and RSV can reduce the risk of severe infections by those viruses, which in turn can reduce the risk that someone could develop pneumonia from secondary infections. Vaccines against the pneumococcus bacteria can reduce pneumonia risk directly. 

Other vaccines against severe infections can also help keep the immune system from overreacting and spiraling into sepsis. 

That’s why it’s important to stay up to date on vaccinations recommended for your age and health status, Taylor said. Talk with your regular health care provider or consult a pharmacist.

Another key source of sepsis risk is skin infections that allow bacteria to enter the bloodstream. Taylor stresses the importance of keeping wounds clean and making sure large wounds are covered or closed properly.