[Systemic inflammatory response syndrome: is it comparable with severe sepsis?].

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Emergency Medicine

Background:

• The 1992 consensus conference established definitions for systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic shock.
• These definitions have been validated for their prognostic utility in numerous studies.
• The prognostic value of these criteria in non-infectious SIRS remains an area for investigation.

Purpose of the Study:

• To determine if the sepsis severity criteria, as defined by the Consensus Conference, are applicable to patients with non-infectious SIRS.
• To compare the outcomes and characteristics of patients with sepsis versus non-infectious SIRS.

Main Methods:

• A prospective evaluation of 518 patients admitted to 5 ICUs across 4 hospitals over 3 months.
• Inclusion criteria required patients to meet at least one severity criterion.
• Data collected included SIRS etiology, organ dysfunction, and patient outcomes.

Main Results:

• 102 patients were included: 79 with sepsis (Group I) and 23 with non-infectious SIRS (Group II).
• Intensive care unit (ICU) and hospital mortality rates were comparable between groups (43% vs. 43% and 48% vs. 51%, respectively).
• Renal dysfunction incidence was higher in the sepsis group, but overall organ dysfunction and ICU stay were similar.

Conclusions:

• The Consensus sepsis severity criteria can be applied to non-infectious SIRS.
• This application identifies a subset of non-infectious SIRS patients with high mortality and significant organ dysfunction.
• Despite similar outcomes, the etiologies of non-infectious SIRS were highly heterogeneous.