Code Sepsis
Part of the Clarion Sentinel Detection Suite

The body is at war with itself

Sepsis is not an infection. It is your immune system's catastrophic overreaction to one — a dysregulated cascade that destroys organs, collapses circulation, and kills 11 million people every year. Every hour of delay costs lives.

7.6%
Mortality increases 7.6% for every hour that appropriate treatment is delayed after sepsis onset. Sentinel Sepsis detects it 4+ hours earlier.
49M
Sepsis cases globally per year
11M
Deaths annually worldwide
1 in 5
Global deaths involve sepsis
$62B
Annual US hospital cost
The Crisis

Sepsis is the leading cause of death in hospitals worldwide. It kills more people than cancer, heart attacks, and stroke combined. Yet it remains one of the most difficult conditions to detect early because its initial presentation — fever, elevated heart rate, altered mental status — mimics dozens of other conditions. By the time a blood culture confirms infection and organ dysfunction scores trigger a sepsis alert, the cascade is already underway and the golden hour has already passed.

Sentinel Sepsis does not wait for the cascade. It detects the earliest immunological, hemodynamic, and metabolic signatures of sepsis onset — 4 to 6 hours before traditional clinical criteria are met — and immediately activates a coordinated response: source identification, empiric antimicrobial therapy, hemodynamic resuscitation, organ protection, and continuous treatment optimization. One platform. Nine engines. The full sepsis response — from first signal to sustained recovery.

The Sepsis Cascade

From infection to organ failure in hours

Sepsis is not a binary event — it is a progressive cascade. Each stage narrows the treatment window and escalates mortality. Sentinel Sepsis monitors every stage simultaneously.

1
Infection & Immune Activation
A localized infection — pneumonia, UTI, surgical site, central line — triggers an immune response. White blood cells release cytokines. Inflammatory mediators enter the bloodstream. At this stage, the infection is manageable. Most patients never progress beyond here.
2
Systemic Inflammatory Response (SIRS)
The immune response escapes the infection site and becomes systemic. Temperature rises or drops abnormally. Heart rate accelerates. Respiratory rate increases. White blood count spikes or crashes. This is the earliest detectable window — but SIRS criteria alone have 90%+ false-positive rates.
Sentinel detects pre-SIRS patterns here — 4-6 hours before clinical criteria
3
Sepsis — Organ Dysfunction Begins
The dysregulated immune response begins damaging the body's own organs. SOFA score rises ≥2 points. Kidneys, liver, brain, lungs, and coagulation system begin to fail — often simultaneously. Lactate rises as tissues starve for oxygen despite adequate circulation. This is where most sepsis is currently diagnosed — and it is already too late for optimal intervention.
Mortality: 15-25% even with treatment
4
Severe Sepsis & Multi-Organ Failure
Multiple organ systems fail concurrently. Acute kidney injury requires dialysis. ARDS requires mechanical ventilation. Hepatic dysfunction distorts coagulation. Encephalopathy clouds consciousness. Each failing organ accelerates the failure of the next — a lethal positive feedback loop.
Mortality: 30-40% with aggressive ICU care
5
Septic Shock
Circulatory collapse despite fluid resuscitation. Vasopressors are required to maintain mean arterial pressure ≥65 mmHg. Lactate exceeds 2 mmol/L. Microcirculatory failure prevents oxygen delivery to tissues even when macro-hemodynamics appear adequate. The mortality clock accelerates exponentially.
Mortality: 40-60% — the highest of any common medical emergency
6
Immunoparalysis & DIC
After the initial cytokine storm, the immune system crashes into a state of profound suppression — immunoparalysis. The patient becomes vulnerable to secondary infections that the body cannot fight. Simultaneously, disseminated intravascular coagulation (DIC) triggers both uncontrolled clotting and bleeding throughout the body. For hematologists and infectious disease specialists, this stage represents the most complex clinical challenge in medicine.
Mortality: 50-70% — often within days of onset
AI-Driven Phenotyping

Not all sepsis is the same

Machine learning has identified four distinct sepsis phenotypes — each with different inflammatory profiles, organ dysfunction patterns, and mortality rates. Sentinel Sepsis classifies each patient in real time, enabling phenotype-specific treatment strategies.

α
Alpha — Mild Dysfunction

Lowest organ dysfunction severity. Minimal inflammation. Typically younger patients with fewer comorbidities. Best prognosis with standard sepsis bundles.

Lowest mortality — responds well to early, standard intervention
β
Beta — Chronic Comorbid

Older patients with chronic kidney disease, diabetes, and vascular disease. Moderate organ dysfunction but prolonged recovery trajectories. Requires renal-protective resuscitation and careful fluid management.

Moderate mortality — comorbidity-driven complexity
γ
Gamma — Hyperinflammatory

Marked inflammatory response with high fevers, elevated CRP, procalcitonin, and ferritin. Respiratory failure develops rapidly. Responds to early, aggressive source control and may benefit from immunomodulatory therapy.

High mortality — cytokine storm pattern
δ
Delta — Coagulopathic Shock

The most severe phenotype. Characterized by profound coagulopathy (DIC), hepatic dysfunction, lactic acidosis, and vasoplegic shock. Requires maximum ICU resources: multiple vasopressors, continuous renal replacement, mechanical ventilation, and hematology co-management for DIC.

Highest mortality — requires maximum-intensity ICU management
Detection & Management Engines

Nine engines. The full sepsis response.

Each engine addresses a distinct domain of sepsis management — from prediction through sustained recovery.

Engine 01
Early Sepsis Prediction
Detects sepsis onset 4-6 hours before clinical criteria through pattern recognition across 200+ variables.
AUC 0.97 — detects 82% of sepsis cases before clinical recognition

Sentinel Sepsis continuously monitors every hospitalized patient across 200+ clinical variables — vital sign trajectories, laboratory trends, medication responses, nursing documentation, and hemodynamic waveforms — to detect the earliest immunological and metabolic signatures of sepsis onset. The system flags sepsis risk 4-6 hours before traditional screening tools (qSOFA, NEWS2, SIRS) trigger, during the critical window when early antibiotics and fluid resuscitation can prevent organ failure entirely.

The model was trained on 18 million de-identified encounters, achieves an AUC of 0.97 for sepsis detection, and maintains an 89% alert adoption rate across deployed sites — because it has been engineered from the ground up to minimize false positives. The system achieves an 8% false-positive rate versus the 90%+ false-positive rate of traditional SIRS-based screening.

Clinical Performance
4-6hr
Earlier detection vs. standard clinical screening tools
0.97
AUC for sepsis detection — independently validated
39.5%
Reduction in in-hospital mortality at deployed sites
8%
False positive rate (vs. 90%+ for SIRS-based screening)
Input Signals (200+)
HR VariabilityTemp TrajectoryMAP TrendLactateWBC DifferentialProcalcitoninCRP TrajectoryRespiratory RateSpO2 TrendCreatinineBilirubinPlatelet TrendMental StatusMedication Response
Engine 02
Infection Source Identification
Localizes the primary infection site using clinical, imaging, and microbiological data — accelerating source control.
Identifies source within 2.4 hours — cutting time to targeted therapy

Source control is the foundation of sepsis treatment. You cannot treat sepsis effectively without knowing where the infection lives. Sentinel Sepsis analyzes the clinical picture — imaging findings, culture results, surgical history, device presence (central lines, urinary catheters, surgical drains), and symptom patterns — to identify the most likely infection source and recommend targeted diagnostic workup and source control interventions. The system identifies pulmonary, urinary, abdominal, central line, skin/soft tissue, and CNS sources with 88% accuracy within the first 2.4 hours of sepsis recognition.

Performance
88%
Source identification accuracy within first 2.4 hours
3.1hr
Faster time to source control procedure
Engine 03
Antimicrobial Stewardship Intelligence
Predicts pathogen, recommends empiric therapy, and optimizes de-escalation as culture data returns.
4.8hr faster time to appropriate antibiotic — the single most impactful variable

Every hour of delay in appropriate antibiotic therapy increases sepsis mortality by 7.6%. But inappropriate broad-spectrum antibiotics fuel antimicrobial resistance — which itself kills 1.27 million people annually. Sentinel Sepsis resolves this tension by predicting the most likely pathogen based on infection source, patient history, local antibiogram, and prior antibiotic exposure — then recommending the narrowest effective empiric coverage. When cultures return (typically 48-72 hours later), the system automatically recommends de-escalation to targeted therapy and flags opportunities to switch from IV to oral formulations.

Performance
4.8hr
Faster time to appropriate antimicrobial therapy
86%
Pathogen prediction accuracy pre-culture
42%
Reduction in unnecessary broad-spectrum antibiotic days
1.27M
Annual AMR deaths globally — the crisis stewardship addresses
Engine 04
Hemodynamic Resuscitation Intelligence
Guides fluid resuscitation and vasopressor management with real-time hemodynamic optimization.
Prevents both under-resuscitation and fluid overload — the two deadliest errors

Sepsis resuscitation is a razor's edge. Too little fluid and the organs starve. Too much fluid and the lungs drown. The Surviving Sepsis Campaign recommends 30 mL/kg crystalloid within 3 hours — but this one-size-fits-all approach does not account for the patient's cardiac function, pulmonary reserve, or volume status. Sentinel Sepsis provides real-time hemodynamic guidance: monitoring MAP, lactate clearance, urine output, ScvO2, pulse pressure variation, and echocardiographic parameters to recommend personalized fluid volumes, vasopressor titration, and the optimal moment to transition from resuscitation to maintenance.

Performance
28%
Reduction in fluid overload-related complications
2.1hr
Faster lactate clearance to target
18%
Reduction in vasopressor duration
Engine 05
Organ Failure Cascade Monitor
Continuous SOFA scoring with predictive organ failure trajectory analysis.
Predicts which organs will fail next — enabling preemptive protection

Sepsis destroys organs in a specific sequence determined by the patient's physiology, comorbidities, and the infection source. Sentinel Sepsis continuously calculates SOFA scores across six organ systems (respiratory, coagulation, liver, cardiovascular, CNS, renal) and projects the trajectory of each — predicting which organs are most likely to fail next and recommending preemptive protective measures (renal-dose adjustment, lung-protective ventilation, neuroprotective strategies) before failure occurs.

Performance
6hr
Advance prediction of next organ system to fail
24%
Reduction in patients progressing to multi-organ failure
Engine 06
Coagulopathy & DIC Intelligence
Detects disseminated intravascular coagulation and guides hematology-driven management.
Built for hematologists — the DIC engine no other platform offers

DIC is the most feared hematological complication of sepsis — a paradox where the blood simultaneously clots and bleeds. Microthrombi form throughout the vasculature, consuming platelets and clotting factors, while the depletion of these factors causes uncontrolled hemorrhage. Sentinel Sepsis continuously monitors the DIC cascade: platelet count trajectory, PT/INR trend, fibrinogen levels, D-dimer, fibrin degradation products, and schistocyte counts. The system calculates real-time ISTH DIC scores, predicts progression from non-overt to overt DIC, and guides hematology-driven management including platelet and cryoprecipitate transfusion thresholds, heparin considerations, and antithrombin replacement.

Performance
8hr
Earlier detection of DIC progression vs. standard labs
91%
Accuracy in predicting non-overt to overt DIC transition
32%
Reduction in DIC-associated hemorrhagic complications
Input Signals
Platelet TrendPT/INRFibrinogenD-DimerFDPSchistocytesISTH ScoreAntithrombin
Engine 07
Immunoparalysis Detection
Identifies the shift from hyperinflammation to immune suppression — the phase where secondary infections kill.
The overlooked phase that causes 60%+ of late sepsis deaths

Most clinicians focus on the cytokine storm — the initial hyperinflammatory phase of sepsis. But it is the second phase — immunoparalysis — that kills the majority of late sepsis deaths. After the immune system exhausts itself fighting the initial infection, it crashes into a state of profound suppression. Monocyte HLA-DR expression plummets. Lymphocyte counts collapse. The patient becomes unable to fight secondary infections — often hospital-acquired organisms like Candida, Pseudomonas, or Acinetobacter that would be manageable in an immunocompetent host. Sentinel Sepsis monitors for this transition using lymphocyte trajectories, monocyte function markers, serial procalcitonin patterns, and secondary infection surveillance — alerting infectious disease teams when immunoparalysis develops and the patient needs a fundamentally different management strategy.

Performance
18hr
Earlier detection of immunoparalysis onset
34%
Reduction in secondary nosocomial infections
Engine 08
Sepsis Bundle Compliance & Quality
Real-time monitoring of Surviving Sepsis Campaign bundle adherence — every element, every hour.
Bundle compliance reduces mortality by 25% — yet average compliance is only 50%

The Surviving Sepsis Campaign's Hour-1 bundle requires: lactate measurement, blood cultures before antibiotics, broad-spectrum antibiotics, 30 mL/kg crystalloid for hypotension, and vasopressors for refractory hypotension — all within the first hour. Compliance with this bundle reduces mortality by 25%. Yet average compliance across US hospitals is approximately 50%. Sentinel Sepsis monitors every element of the bundle in real time, identifies compliance gaps as they occur, and alerts the care team to act — transforming a paper checklist into an automated, intelligent enforcement system.

Performance
94%
Bundle compliance rate (vs. 50% national average)
32min
Average time to complete Hour-1 bundle
Engine 09
Post-Sepsis Syndrome & Recovery Intelligence
Monitors survivors through the critical 90-day post-sepsis period when readmission and mortality remain elevated.
40% of sepsis survivors are readmitted within 90 days — most preventably

Surviving sepsis is not the end of the story. Up to 40% of sepsis survivors are rehospitalized within 90 days. Many experience post-sepsis syndrome — persistent cognitive impairment, functional disability, chronic pain, anxiety, depression, and profound fatigue — that can last months to years. Sentinel Sepsis continues monitoring survivors after discharge through post-discharge symptom questionnaires, medication adherence tracking, primary care coordination, and early readmission risk scoring — ensuring that the investment in acute survival translates into sustained recovery.

Performance
22.7%
Reduction in 30-day readmission rate
90day
Continuous post-discharge surveillance window
Proven Impact

Lives saved. Organs protected. Cascades stopped.

Results from our deployed health systems.

Multi-Hospital Health System — 9 Facilities

System-wide sepsis mortality reduction through AI-driven early detection

The Outcome

Deployed across 9 hospitals and 2 emergency departments, Sentinel Sepsis detected 82% of sepsis cases before clinical recognition. Alert adoption rates reached 89%. In-hospital sepsis mortality dropped 39.5%. Average length of stay for sepsis patients decreased 32.3%. Thirty-day readmission rates fell 22.7%. In the first year, the system identified 4,220 actionable sepsis cases where clinician response within 3 hours of the alert produced an 18.7% relative mortality reduction compared to delayed response.

39.5%
Mortality reduction
32.3%
LOS decrease
22.7%
Readmission reduction
89%
Alert adoption rate
Academic Medical Center — Hematology Division

DIC detection and hematology-guided management in septic shock

The Outcome

The hematology division deployed the DIC Intelligence engine across all ICU patients with sepsis. The system detected the transition from non-overt to overt DIC an average of 8 hours before standard laboratory-based recognition, enabling earlier initiation of targeted management — platelet and cryoprecipitate transfusion, antithrombin replacement, and careful anticoagulation. DIC-associated hemorrhagic complications dropped 32%. Hematology consultation was triggered automatically at the first sign of coagulopathic decompensation rather than hours later when the bleeding was already uncontrolled.

8hr
Earlier DIC detection
32%
Fewer hemorrhagic events
Auto
Hematology consult trigger
91%
DIC prediction accuracy
Emergency Department Network — 4 Sites

Hour-1 bundle compliance transformation

The Outcome

Four emergency departments deployed Sentinel Sepsis to enforce Hour-1 bundle compliance in real time. Average time to complete all bundle elements dropped from 3.2 hours to 32 minutes. Bundle compliance rose from 48% to 94%. The most impactful element: time to first antibiotic decreased from 128 minutes to 38 minutes — a change that, given the 7.6% mortality increase per hour of delay, translated directly into lives saved. Emergency physicians reported that the system's phenotype classification changed their resuscitation approach in 34% of cases.

94%
Bundle compliance
32min
Bundle completion time
128→38
Minutes to first antibiotic
34%
Cases where phenotype changed approach
Clinician Voices

I have been an infectious disease specialist for nineteen years. Sentinel Sepsis fundamentally changed how I practice. The phenotyping alone — knowing within the first hour whether I'm dealing with an alpha or a delta — changes everything about how I approach antimicrobials, resuscitation, and when I call hematology. This is not a screening tool. This is the operating system for sepsis management.

Division Chief, Infectious Diseases
Board Certified, 19 Years Practice
Academic Medical Center

The DIC engine is what I've been waiting my entire career for. By the time I used to get the hematology consult, the patient was already hemorrhaging. Now the system alerts me when the coagulopathy is still in its non-overt phase — when I can actually intervene rather than react. That's not a marginal improvement. That's a paradigm shift in how we manage sepsis-associated coagulopathy.

Director of Hematology
Fellowship-Trained Hematologist
850-Bed Teaching Hospital

We reduced our time to first antibiotic from over two hours to thirty-eight minutes. When you understand that every hour of delay increases mortality by 7.6%, that single metric means we're saving lives every single shift. Every single one. The system paid for itself in the first month.

Emergency Department Medical Director
Board Certified, Emergency Medicine
Level I Trauma Center
39.5%
Mortality reduction
4-6hr
Earlier detection
94%
Bundle compliance
340+
Hospitals deployed
Every Hour Counts

Stop the cascade before it starts

Schedule a clinical demonstration of Sentinel Sepsis — configured for your patient population, your ICU acuity, and your infectious disease protocols.

Or contact our clinical team at sepsis@brindwell.com