Utility of Systemic Inflammatory Response Syndrome (SIRS) Criteria in Trauma Triage

2006 ◽  
Vol 13 (5Supplement 1) ◽  
pp. S40-S40
Author(s):  
G. S. Doyle
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Systemic Inflammatory Response ◽  
Trauma Triage ◽  
Sirs Criteria

scholarly journals Antimicrobial utilization pattern in Systemic Inflammatory Response Syndrome positive septicemia: a prospective study in an apex hospital in South Delhi

2019 ◽  
Vol 8 (3) ◽  
pp. 557
Author(s):  
Anwer Habib ◽  
Razi Ahmad
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
High Risk Patient ◽  
Systemic Inflammatory Response ◽  
Early Initiation ◽  
Source Of Infection ◽  
Sepsis And Septic Shock ◽  
Sirs Criteria

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.

Comparative study of the performance of SOFA and qSOFA versus SIRS criteria for predicting mortality among septic patients admitted to the intensive care unit

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Naglaa Mohammad Aly ◽  
Mustafa Mansour Hussein ◽  
Mohammad Mohammad Kamal Abd Allah ◽  
Mustafa Youssef Abd-El Magid
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Hospital Mortality ◽  
Comparative Study ◽  
Sofa Score ◽  
Systemic Inflammatory Response ◽  
Suspected Infection ◽  
Sirs Criteria

Abstract Background Sepsis is considered one of a life-threatening condition among intensive care unit (ICU) patients. Although, there are evidence-based management guidelines, sepsis still remains a leading cause of death with in-hospital mortality ranging from 22.8% to 48.7%. Previously sepsis was defined as systemic inflammatory response to infection, which could be diagnosed by meeting two or more Systemic Inflammatory Response Syndrome (SIRS) criteria, along with a known or suspected infection. Even though the SIRS criteria were sensitive, but they were not specific enough to differentiate between sepsis and other inflammatory conditions. Objective To compare between the ability of SOFA score, the quick SOFA (qSOFA) and Systemic Inflammatory Response Syndrome (SIRS) to predict ICU mortality. Patients and Methods Randomized prospective comparative study conducted in El Haram Specialized Hospital. The study included 75 patients. We calculated SOFA, SIRS, and qSOFA scores based on physiological and laboratory data that were collected upon admission to the ICU. Standard criteria were applied with a threshold of 2 or more points for each scoring system. The baseline SOFA score was assumed to be zero for patients without a known preexisting organ dysfunction. The baseline total SOFA score was considered to be 4 for patients undergoing chronic dialysis, and 2 or 3 for cirrhotic patients, depending on baseline bilirubin levels. Results ROC curve analysis between survival and each of SIRS, qSOFA and SOFA, it shows that SOFA score presented the best discrimination with an AUC of 0.993 (95% CI 0.981–100). Conclusion In patients with suspected infection admitted to an ICU, an increase in SOFA score had greater prognostic accuracy for in-hospital mortality than SIRS criteria or qSOFA. These findings suggest that SIRS and qSOFA may have limited use for predicting mortality in an ICU setting.

scholarly journals Evolving Definition and Diagnostic Criteria of Sepsis

2021 ◽  
pp. 391-397
Author(s):  
V. Rakshana ◽  
A. S. Arunkumar ◽  
Laya Mahadevan
Keyword(s):  
Critical Care ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Diagnostic Criteria ◽  
Scoring System ◽  
Routine Care ◽  
Systemic Inflammatory Response ◽  
Ongoing Process ◽  
Healthcare Settings ◽  
Sirs Criteria

For many years, the Systemic Inflammatory Response Syndrome (SIRS) criteria were primarily considered for the diagnosis of sepsis, promoting the importance of inflammation. The definition and dia        gnostic criteria of sepsis has undergone a sizeable metamorphosis from the inception of standardized definitions of sepsis in 1991. In 1991, the American College of Chest Physicians (ACCP) and the Society of Critical Care Medicine (SCCM) convened in Chicago and emphasized that sepsis is an ‘ongoing process’ of infection and considered SIRS score of two or more for diagnosis of sepsis. SOFA scoring system is an easily calculated system using parameters that are usually obtained during routine care of patients. This ensures that delays are avoided from requirement of any special investigations, making it reproducible in any number of healthcare settings.

scholarly journals Utilization of Systemic Inflammatory Response Syndrome Criteria in predicting mortality among geriatric patients with influenza in the emergency department

2019 ◽  
Author(s):  
Henry Chih-Hung Tai ◽  
Chien-Chun Yeh ◽  
Yen-An Chen ◽  
Chien-Chin Hsu ◽  
Jiann-Hwa Chen ◽  
...  
Keyword(s):  
Emergency Department ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Goodness Of Fit ◽  
Geriatric Patients ◽  
Statistical Significance ◽  
Mortality Prediction ◽  
Systemic Inflammatory Response ◽  
Goodness Of Fit Test ◽  
Sirs Criteria

Abstract Background Systemic Inflammatory Response Syndrome (SIRS) criteria are often used to evaluate the risk of sepsis and to identify in-hospital mortality among patients with suspected infection. However, utilization of the SIRS criteria in mortality prediction among geriatric patients with influenza in the emergency department (ED) remains unclear. Therefore, we conducted a research to delineate this issue. Methods This is a retrospective case–control study including geriatric patients (age ≥ 65 years) with influenza, who presented to the ED of a medical center between January 1, 2010 and December 31, 2015. Vital signs, past history, subtype of influenza, demographic data, and outcomes were collected from all patients and analyzed. We calculated the accuracy for predicting 30-days mortality using the SIRS criteria. We also performed covariate adjustment of the area under the receiver operating characteristic curve (AUROC) via regression modeling. Results We recruited a total of 409 geriatric patients in the ED, with mean age 79.5 years and an equal sex ratio. The mean SIRS criteria score was 1.9±1.1. The result of a Hosmer–Lemeshow goodness-of-fit test was 0.34 for SIRS criteria. SIRS criteria score ≥ 3 showed better mortality prediction, with odds ratio (OR) 3.37 (95% confidence interval (CI), 1.05–10.73); SIRS score ≥ 2 showed no statistical significance, with p = 0.85 (OR, 1.15; 95% CI, 0.28–4.69). SIRS score ≥ 3 had acceptable 30-days mortality discrimination, with AUROC 0.77 (95% CI, 0.68–0.87) after adjustment. SIRS score ≥ 3 also had a notable negative predictive value of 0.97 (95% CI, 0.94–0.99). Conclusion The presence of a higher number of SIRS criteria (≥ 3) showed greater accuracy for predicting mortality among geriatric patients with influenza.

Abstract TP278: Prevalence Of Systemic Inflammatory Response Syndrome and its Impact On Outcome In Acute Ischemic Stroke Patients Receiving IV tPA Therapy

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Niren Kapoor ◽  
Amelia K Boehme ◽  
Karen C Albright ◽  
Michael J Lyerly ◽  
Reza Bavarsad Shahripour ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Length Of Stay ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Acute Ischemic Stroke ◽  
Functional Outcomes ◽  
Systemic Inflammatory Response ◽  
Short Term ◽  
Sirs Criteria ◽  
Iv Tpa

Background: Systemic Inflammatory Response Syndrome (SIRS) is a generalized inflammatory state linked to a release of various pro- and anti-inflammatory cytokines and associated with fibrin deposition, platelet aggregation, and coagulopathies. Although SIRS is associated with various inflammatory and ischemic conditions, its prevalence and impact on patients with acute ischemic stroke (AIS) has not been extensively studied. Methods: A retrospective cross sectional study was used to look at the prevalence of SIRS and its impact on outcome in AIS patients treated with IV tPA between 2009-2011 at our tertiary care center. SIRS was diagnosed if two or more of the following were present: temperature < 36°C or > 38°C, heart rate > 90/min, respiratory rate >20/min or PaCO 2 <32 mmHg and WBC count <4000/mm 3 or >12000/mm 3 or 10% bands. Patients meeting the SIRS criteria for at least 24h were included in the study. Patients with signs of active infection such as pneumonia, UTI, bacteremia, and sinusitis or deep venous thrombosis were excluded from the study. The discharge modified Rankin score (mRS) was used to compare the short-term outcomes between patients with and without SIRS. An mRS of 4-6 was used to define poor functional outcome. Results: Out of the 212 patients screened, 44 met the SIRS criteria (21%). The median NIHSS for SIRS patients was 9 (range 0-32). SIRS patients were more likely to have a longer length of stay than non-SIRS patients (5 vs. 3 days; p<0.0001). Patients with SIRS had worse functional outcomes compared to patients without SIRS (OR=2.824, 95% CI, 1.358 - 5.871, p=0.0054). Adjusting for pre-tPA NIHSS, age and race, SIRS remained a predictor of poor outcome (OR= 2.581, 95% CI, 1.163 - 5.727, p=0.0197). Presence of SIRS did not have a significant effect upon in-hospital mortality (OR=1.978, 95% CI, 0.774 - 5.057, p=0.1545). Conclusions: One out of five AIS patients treated with IV tPA developed SIRS. The presence of SIRS is associated with poor short-term functional outcomes and prolonged length of stay.

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