SIRS in ICU: a different approach in sepsis assessment: clinical predictivity, severity scores, costs
© Current Science Ltd 1997
Published: 1 March 1997
The systemic inflammatory response syndrome (SIRS), based on the changes of four physiological features like temperature, white cells, heart rate and ventilation, can be observed after a wide variety of insults.
Because sepsis is the systemic response to infection and it is the most common cause of death and of multiple organ failure (MOF) in ICU, we have tried to use SIRS as a predictive tool against the risk of sepsis, severe sepsis and septic shock.
Many authors chose two of the four criteria of SIRS to verify this hypothesis, but results were misleading: a significant predictive power of SIRS against sepsis was not found.
Although SIRS is not disease specific, we performed a retrospective study on 384 unselected patients admitted consecutively to our ICU from 1 January 1993 to 31 May 1995, connecting epidemiological data to our research.
We found that three-four criteria of SIRS (group SIRS 1) are significantly better than the two criteria pattern (group SIRS 2) as predictive power.
This result was confirmed by the significant difference of APACHE III and SAPS II scores (87 and 55 respectively versus 78 and 48), by the longer length of stay of survivors (24 days versus 12) and by bigger costs (78 million versus 38 million Italian lire) in the group SIRS 1.
We concluded that by adding one or two SIRS criteria to those normally used, the predictive liability of SIRS against risk of sepsis is significantly enhanced.