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SIRS and Severe Sepsis Screening
- Sepsis remains one of the most common critical illnesses managed by emergency medicine and critical care physicians.
- Many EDs and ICUs have screening protocols for early detection of the patient with sepsis. Most protocols use the systemic inflammatory response syndrome (SIRS) as a central component of early identification.
- A recent study stresses caution when simply using the SIRS criteria to screen for severe sepsis:
- Retrospective review of the ANZICS Adult Database
- Divided patients into SIRS-positive ( 2 SIRS criteria with at least 1 organ failure) and SIRS-negative ( < 2 SIRS criteria with at least 1 organ failure)
- 109,663 patients
- 12% of patients diagnosed with severe sepsis or at least 1 organ failure had < 2 SIRS criteria at admission.
- Mortality for the SIRS-negative cohort remained relatively high at 16.1%
- Take Home Point
- Using the SIRS criteria to screen patients for severe sepsis will miss 1 out of every 8 patients with infection and organ dysfunction.
References
Kaukonen KM, Bailey M, Pilcher D, et al. Systemic Inflammatory Response Syndrome Criteria in Defining Severe Sepsis. NEJM 2015;372:1629-38.