Intensive Care Medicine

, 34:1654 | Cite as

Does severe non-infectious SIRS differ from severe sepsis?

Results from a multi-centre Australian and New Zealand intensive care unit study
  • Joel M. Dulhunty
  • Jeffrey Lipman
  • Simon Finfer
  • the Sepsis Study Investigators for the ANZICS Clinical Trials Group
Original

Abstract

Objective

To compare the time course of organ dysfunction/failure, mortality and cause of death in patients with severe sepsis (SS) and patients with severe non-infectious systemic inflammatory response syndrome (SNISIRS).

Design

Secondary analysis of a multi-centre inception cohort study.

Setting

Twenty-three multidisciplinary intensive care units (ICUs) in Australia and New Zealand.

Patients and participants

3,543 ICU admissions ≥48 h or <48 h if SIRS and organ dysfunction present.

Interventions

None.

Measurements and results

ICU prevalence of SS and SNISIRS was 20% (707/3,543) and 28% (980/3,543), respectively. ICU mortality was similar in patients with SNISIRS and with SS (25 vs. 27%, P = 0.40). Central nervous system (CNS) failure occurred more frequently in patients with SNISIRS (33 vs. 22%, P < 0.001) and resulted in death more commonly than in SS (relative risk = 1.6, 95% confidence interval 1.4–1.7, P < 0.001). The time to peak organ dysfunction (0.67 vs. 0.91 days, P = 0.004), overall episode length (3.6 vs. 5.6 days, P < 0.001) and ICU stay (geometric mean: 4.1 vs. 5.8 days, P < 0.001) were significantly shorter in patients with SNISIRS.

Conclusions

Whilst SNISIRS and SS have similarities, including their crude mortality rate, important differences exist. SNISIRS is more common on admission to the ICU, and is more commonly coupled with CNS dysfunction and death from neurological failure.

Descriptors

SIRS/sepsis: clinical studies.

Keywords

Sepsis Severe sepsis SIRS Epidemiology 

Notes

Acknowledgments

We wish to acknowledge the medical and nursing staff at the 21 participating hospitals that were associated with this research. Preparation of this manuscript was assisted by a grant from the Royal Brisbane and Women’s Hospital Research Foundation (Dr. Dulhunty).

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Joel M. Dulhunty
    • 1
  • Jeffrey Lipman
    • 1
    • 2
  • Simon Finfer
    • 2
    • 3
  • the Sepsis Study Investigators for the ANZICS Clinical Trials Group
  1. 1.Department of Intensive Care MedicineRoyal Brisbane and Women’s Hospital, and Burns, Trauma and Critical Care Research Centre, University of QueenslandHerstonAustralia
  2. 2.ANZICS Clinical Trials GroupCarltonAustralia
  3. 3.Royal North Shore Hospital and The George Institute for International Health, University of SydneySydneyAustralia

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