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Intensive Care Medicine

, Volume 29, Issue 8, pp 1368–1371 | Cite as

The systemic inflammatory response syndrome (SIRS) to identify infected patients in the emergency room

  • Fabián Jaimes
  • Jenny Garcés
  • Jorge Cuervo
  • Federico Ramírez
  • Jorge Ramírez
  • Andrea Vargas
  • Claudia Quintero
  • Jorge Ochoa
  • Fabio Tandioy
  • Láder Zapata
  • Juan Estrada
  • Maria Yepes
  • Hiulber Leal
Brief Report

Abstract

Objective

Evaluation of the usefulness of criteria for systemic inflammatory response syndrome (SIRS) compared with the final diagnosis of infection in patients admitted to the emergency room of two university-based hospitals.

Design

Longitudinal cohort study.

Setting

Hospital Universitario San Vicente de Paul and Hospital General de Medellín, Medellín, Colombia.

Patients

Seven hundred thirty-four patients with suspected infection as main diagnosis for admittance into the emergency room.

Measurements and results

Sensitivity, specificity, predictive values and likelihood ratios (LR) of SIRS criteria at admission were determined using, as gold standards, the diagnosis at the time of discharge based on clinical history and evolution, and microbiological confirmation of infection. SIRS criteria were met by 503 patients (68.5%); the discharge diagnosis of infection was found in 657 (89.4%) and 276 (37%) had microbiological confirmation. SIRS criteria exhibited a sensitivity of 69%, specificity of 35%, positive predictive value (PPV) of 90%, negative predictive value (NPV) of 12% and positive LR of 1.06. There were no differences between the two gold standards.

Conclusions

The finding of two or more SIRS criteria was of little usefulness for diagnosis of infection. It is necessary to work with new criteria and probably with biological markers, in order to obtain a simple, precise and operative definition of the sepsis phenomenon.

Keywords

Sepsis Systemic inflammatory response syndrome Diagnosis Sensitivity 

Notes

Acknowledgements

We are indebted to the staff of emergency services at Hospital San Vicente de Paul and Hospital General de Medellin for their collaboration. Acknowledgements to María Teresa Rugeles and Rodolfo Dennis for suggestions and manuscript review.

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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Fabián Jaimes
    • 1
  • Jenny Garcés
    • 1
  • Jorge Cuervo
    • 1
  • Federico Ramírez
    • 1
  • Jorge Ramírez
    • 1
  • Andrea Vargas
    • 1
  • Claudia Quintero
    • 1
  • Jorge Ochoa
    • 1
  • Fabio Tandioy
    • 1
  • Láder Zapata
    • 1
  • Juan Estrada
    • 1
  • Maria Yepes
    • 1
  • Hiulber Leal
    • 1
  1. 1.School of MedicineUniversity of AntioquiaMedellinColombia

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