An evaluation of systemic inflammatory response syndrome signs in the Sepsis Occurrence in Acutely ill Patients (SOAP) study
- 1.2k Downloads
To define the frequency and prognostic implications of SIRS criteria in critically ill patients hospitalized in European ICUs
Design and setting
Cohort, multicentre, observational study of 198 ICUs in 24 European countries.
Patients and interventions
All 3,147 new adult admissions to participating ICUs between 1 and 15 May 2002 were included. Data were collected prospectively, with common SIRS criteria.
During the ICU stay 93% of patients had at least two SIRS criteria [respiratory rate (82%), heart rate (80%)]. The frequency of having three or four SIRS criteria vs. two was higher in infected than non-infected patients (p < 0.01). In non-infected patients having more than two SIRS criteria was associated with a higher risk of subsequent development of severe sepsis (odds ratio 2.6, p < 0.01) and septic shock (odds ratio 3.7, p < 0.01). Organ system failure and mortality increased as the number of SIRS criteria increased.
Although common in the ICU, SIRS has prognostic importance in predicting infections, severity of disease, organ failure and outcome.
KeywordsInfections Systemic inflammatory response syndrome Sepsis Severe sepsis Septic shock Prognosis
This research was endorsed by the European Society for Intensive Care Medicine, and supported by an unlimited grant from Abbott, Baxter, Eli Lilly, GlaxoSmithKline and NovoNordisk.
- 16.Vincent JL, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S (1998) Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicentric, prospective study. Crit Care Med 26:1793–1800PubMedGoogle Scholar
- 17.Alberti C, Brun-Buisson C, Goodman SV, Guidici D, Granton J, Moreno R, Smithies M, Thomas O, Artigas A, Le Gall JR; European Sepsis Group (2003) Influence of systemic inflammatory response syndrome and sepsis on outcome in critically ill infected patients. Am J Respir Crit Care Med 168:77–84PubMedCrossRefGoogle Scholar
- 20.Jones GR, Lowes JA (1996) The systemic inflammatory response syndrome 1as a predictor of bacteraemia and outcome from sepsis. Q J Med 89:515–522Google Scholar
- 21.Alberti C, Brun-Buisson C, Chevret S, Antonelli M, Goodman SV, Martin C, Moreno R, Ochagavia AR, Palazzo M, Werdan K, Le Gall JR, European Sepsis Study Group (2005) Systemic inflammatory response and progression to severe sepsis in critically ill infected patients. Am J Respir Crit Care Med 171:461–468PubMedCrossRefGoogle Scholar
- 23.Bernard GR, Vincent JL, Laterre PF, La Rosa SP, Dhainaut JF, Lopez-Rodriguez A, Steingrub JS, Garber GE, Helterbrand JD, Ely EW, Fisher CJ Jr, Recombinant Human protein C Worldwide Evaluation in Severe Sepsis (PROWESS) Study Group (2001) Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 344:699–709PubMedCrossRefGoogle Scholar
- 24.Annane D, Sebille V, Charpentier C, Bollaert PE, Francois B, Korach JM, Capellier G, Cohen Y, Azoulay E, Troche G, Chaumet-Riffaut P, Bellissant E (2002) Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288:862–871PubMedCrossRefGoogle Scholar