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Volume 17 Supplement 4

Sepsis 2013

Open Access

SIRS criteria as predictors of mortality in patients admitted with sepsis

  • Adriell Ramalho Santana1,
  • Jaqueline Lima de Souza1,
  • Fábio Ferreira Amorim1,
  • Felipe Bozi Soares1,
  • Bárbara Magalhães Menezes1,
  • Mariana Pinheiro Barbosa de Araújo1,
  • Fernanda Vilas Bôas Araújo1,
  • Louise Cristhine de Carvalho Santos1,
  • Pedro Henrique Gomes Rocha1,
  • Lucila de Jesus Almeida1,
  • Thais Almeida Rodrigues1,
  • Pedro Nery Ferreira Júnior1,
  • Alethea Patrícia Pontes Amorim2,
  • José Aires de Araújo Neto3,
  • Edmilson Bastos de Moura3 and
  • Marcelo de Oliveira Maia3
Critical Care201317(Suppl 4):P54

https://doi.org/10.1186/cc12954

Published: 5 November 2013

Keywords

Relative RiskReceiver Operating CharacteristicSeptic ShockEmergency MedicineReceiver Operating Characteristic Curve

Background

The ACCP/SCCM consensus conference definitions for sepsis are used worldwide [1]. However, consensus definitions do not adequately reflect the intricacies of sepsis and can overestimate the diagnosis due to their high sensitivity. Moreover, the consensus criteria do not allow the staging or the prediction of sepsis outcome [2]. This study aims to evaluate the individual components of SIRS criteria as predictors of mortality in patients admitted to an ICU with sepsis.

Materials and methods

A case-control study conducted in the ICU of Hospital Santa Luzia, Brasilia, DF, Brazil, during 4 months. Patients were divided into two groups: survivors group (SG) and nonsurvivors group (NSG). The accuracy of individual components of SIRS criteria as predictors of mortality was measured with the area under the receiver operating characteristic (ROC) curve.

Results

A total of 76 patients were enrolled, 10.5% (n = 8) with septic shock. Age was 70 ± 18 years, SAPS3: 52.9 ± 13.9, APACHE II: 15.5 ± 8.8. The ICU length of stay was 9 ± 10 days. ICU mortality was 21% (n = 16). The most prevalent sites of infections were respiratory (57.9%, n = 44), followed by urinary (25%, n = 19) and cutaneous (6.6%, n = 5). The incidence of tachycardia was the only parameter higher in the NSG (37.5% vs. 9.1%, P = 0.00). There was no difference regarding the incidence of fever or hypothermia (15.4% vs. 24.0%, P = 0.38), tachypnea (25.0% vs. 17.5%, P = 0.42) or leukocytosis or leucopenia (20.9% vs. 21.2%, P = 0.97) between the groups. The relative risk of death in patients with tachycardia was 4.13 (95% CI: 1.46 to 11.63). Tachycardia also had the larger area under the ROC curve: 0.708 (95% CI: 0.566 to 0.850), versus 0.442 (95% CI: 0.287 to 0.597) for fever/hypothermia, 0.556 (95% CI: 0.397 to 0.715) for tachypnea, and 0.498 (95% CI: 0.338 to 0.658) for leukocytosis/leucopenia.

Conclusions

For this sample, tachycardia was the only SIRS component associated with ICU mortality in patients admitted with sepsis.

Authors’ Affiliations

(1)
Escola Superior de Ciências da Saúde, Brasília, Brazil
(2)
Liga Acadêmica de Medicina Intensiva de Brasília, Brazil
(3)
Hospital Santa Luzia, Brasília, Brazil

References

  1. Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G: 2001 SCCM/ESICM/ACCP/ ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003, 31: 1250-1256. 10.1097/01.CCM.0000050454.01978.3B.View ArticlePubMedGoogle Scholar
  2. Vincent JL: Dear SIRS, I'm sorry to say that I don't like you. Crit Care Med. 1997, 25: 372-374. 10.1097/00003246-199702000-00029.View ArticlePubMedGoogle Scholar

Copyright

© Santana et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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