Prognostic value of assessing contact system activation and factor V in systemic inflammatory response syndrome

Background. Although recently challenged, systemic inflammatory response syndrome (SIRS) criteria are still commonly used in daily practice to define sepsis. However, several factors in liver cirrhosis may negatively impact its prognostic ability. Goals. To investigate the factors associated with the presence of SIRS, the characteristics of SIRS related to infection, and its prognostic value among patients hospitalized for acute decompensation of cirrhosis. Study. In this cohort study from two tertiary hospitals, 543 patients were followed up, up to 90 days. Data collection, including the prognostic models, was within 48 hours of admission. Results. SIRS was present in 42.7% of the sample and was independently associated with upper gastrointestinal bleeding (UGB), ACLF, infection, and negatively related to beta-blockers. SIRS was associated with mortality in univariate analysis, but not in multiple Cox regression analysis. The Kaplan–Meier survival probability of patients without SIRS was 73.0% and for those with SIRS was 64.7%. The presence of SIRS was not significantly associated with mortality when considering patients with or without infection, separately. Infection in SIRS patients was independently associated with Child-Pugh C and inversely related to UGB. Among subjects with SIRS, mortality was independently related to the presence of infection, ACLF, and Child-Pugh C. Conclusions. SIRS was common in hospitalized patients with cirrhosis and was of no prognostic value, even in the presence of infection.

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Systemic Inflammatory Response Syndrome Due to Surgery and its Effective Therapeutic Approaches

Journal of Shahid Sadoughi University of Medical Sciences ◽

10.18502/ssu.v28i5.3971 ◽

2020 ◽

Author(s):

Moosa Javdani ◽

Abolfazl Barzegar-Bafrouei

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Inflammatory Cytokines ◽

Surgical Stress ◽

Systemic Inflammatory Response ◽

The Body ◽

System Activation ◽

Anti Inflammatory ◽

Postoperative Stress ◽

Inflammatory Syndrome

Introduction: Various lesions trigger an inflammatory response in the host body. These injuries include surgical stress Surgery exerts stress on the body. Systemic inflammatory syndrome is a reflection of the degree of surgical stress and as a system of assessing the severity of postoperative stress. Regular complexes of inflammatory polypeptide molecules contribute to the development of this inflammatory response known as cytokines. Lack of local control over the release of these cytokines can cause systemic inflammation, and potentially devastating complications. In writing this review articles, articles indexed in the following databases were used: Science Direct, Scopus, Springer Science, PubMed and Google Scholar Ninety two related research papers, including quantitative and qualitative researches in English, related to the last 40 years (1979- 2019) were included in this study. The current review article has been written based on 92 articles and the keywords of “Surgical Stress, Systemic Inflammatory Response Syndrome, Pro-Inflammatory Cytokines, and Anti-Inflammatory Cytokines”. Studies in humans and animal models suggest that both types of pro-inflammatory and anti-inflammatory cytokines following diverse primary stimuli, including endotoxin release, complement system activation, ischemia-perfusion injury, and other ways. Conclusion: Inflammatory and anti-inflammatory cytokines are the result of a complex unpredictable interaction of immune system effects on the body and even multiple effects on body organs. New therapeutic strategies for the absorption of cytokines are a powerful way to enhance and improve proper output, following systemic inflammatory response syndrome.

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