scholarly journals The Natural History of the Systemic Inflammatory Response Syndrome and the Evaluation of SIRS Criteria as a Predictor of Severity in Patients Hospitalized through Emergency Services.

1999 ◽  
Vol 48 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Dong Sun ◽  
Naoki Aikawa
JAMA ◽  
1995 ◽  
Vol 273 (2) ◽  
pp. 117 ◽  
Author(s):  
M. Sigfrido Rangel-Frausto ◽  
Didier Pittet ◽  
Michele Costigan ◽  
Taekyu Hwang ◽  
Charles S. Davis ◽  
...  

Author(s):  
Luana Matuella Figueira da Silva ◽  
Luciano Passamini Diogo ◽  
Letícia Becker Vieira ◽  
Fabiano Da Costa Michielin ◽  
Michelle Dornelles Santarem ◽  
...  

Objective: to evaluate the performance of the quickSOFA scores and Systemic Inflammatory Response Syndrome as predictors of clinical outcomes in patients admitted to an emergency service. Method: a retrospective cohort study, involving adult clinical patients admitted to the emergency service. Analysis of the ROC curve was performed to assess the prognostic indexes between scores and outcomes of interest. Multivariate analysis used Poisson regression with robust variance, evaluating the relationship between variables with biological plausibility and outcomes. Results: 122 patients were selected, 58.2% developed sepsis. Of these, 44.3% had quickSOFA ≥2 points, 87% developed sepsis, 55.6% septic shock and 38.9% died. In the evaluation of Systemic Inflammatory Response Syndrome, 78.5% obtained results >2 points; of these, 66.3% developed sepsis, 40% septic shock and 29.5% died. quickSOFA ≥2 showed greater specificity for diagnosis of sepsis in 86% of the cases, for septic shock 70% and for mortality 64%, whereas the second score showed better results for sensitivity with diagnosis of sepsis in 87.5%, septic shock in 92.7% and death in 90.3%. Conclusion: quickSOFA showed by its practicality that it can be used clinically within the emergency services, bringing clinical applicability from the risk classification of patients for the early recognition of unfavorable outcomes.


Author(s):  
Anwer Habib ◽  
Razi Ahmad

Background: Despite significant advances in critical care, mortality and morbidity in severe sepsis and septic shock remain high, this may be explained by the fact that in sepsis bacterial infection triggers the innate immune response, setting in motion a cascade of pro-inflammatory and anti-inflammatory cytokines leading to what we recognize as the systemic inflammatory response syndrome (SIRS). It has been thought that this self-propagating cascade drives the progression to severe sepsis and septic shock with increasing degrees of cellular injury and end-organ dysfunction, therefor early initiation of empirical antimicrobial agent is crucial and life-saving atleast in high risk patient. This study aimed to see the outcome (recover or mortality) of patients diagnosed by using SIRS criteria.Methods: Total of 105 patients of suspected sepsis fulfilling SIRS criteria (SIRS ≥2), were included in study. Study population were administered appropriate empirical antimicrobial depending on the source of infection and followed till the final outcome (complete recovery or death).Results: Out of 105 patients included in study based on SIRS criteria, 87 (82.85%) were confirmed to be having septicemia on further evaluation. In majority of patient primary source of infection were respiratory tract (44.76%) and most commonly employed and effective empirical antimicrobial were a combination piperacillin with tazobactum and amikacin (40%). 92.39% patients recovered with empirical antimicrobial, with total in-hospital mortality rate of 7.61%.Conclusions: Early initiation of appropriate antimicrobial by using SIRS as an indicator for the early diagnosis of septicemia is crucial in the management of septicemia and prevention of development of severe sepsis, septic shock.


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