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Prevalence of systemic inflammatory response syndrome (SIRS) in hospitalized children: a point prevalence study
Jana Pavare1, Ilze Grope, Dace Gardovska
1Riga Stradins University, Chair of Pediatrics, Riga, Latvia. jana.pavare@inbox.lv
Insights
Children with Systemic Inflammatory Response Syndrome (SIRS) and fever face a high risk of developing sepsis. Early recognition of SIRS in pediatric patients is crucial for timely sepsis treatment and improved outcomes.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Clinical epidemiology
Background:
- Sepsis is defined as Systemic Inflammatory Response Syndrome (SIRS) with suspected or confirmed infection.
- Assessing SIRS and sepsis prevalence in febrile children is essential.
- Previous international consensus defined sepsis criteria for pediatric patients.
Purpose of the Study:
- To determine the prevalence of SIRS and sepsis in children with abnormal temperatures.
- To evaluate the progression of SIRS to sepsis in a pediatric hospital setting.
- To identify risk factors and clinical characteristics associated with SIRS in children.
Main Methods:
- A descriptive, prospective, point prevalence study was conducted.
- Included 943 hospitalized children, focusing on 92 with abnormal temperatures (fever or hypothermia).
- Age-specific SIRS criteria were assessed using questionnaires; prevalence was calculated with 95% confidence intervals.
Main Results:
- 10% of hospitalized children had abnormal temperatures, exclusively fever.
- 72% of febrile children met SIRS criteria; 8% of SIRS patients developed sepsis.
- SIRS was frequently associated with fever and elevated respiratory rate; most affected children were aged 2-5 years. No diagnoses were recorded by clinicians.
Conclusions:
- Children with SIRS exhibit a high risk of progressing to sepsis.
- Early diagnosis of SIRS and awareness of sepsis risk are vital for clinical practice.
- Prompt, goal-directed therapy for sepsis can be facilitated by early recognition.
Background:
In accordance with the 1st International pediatric sepsis consensus conference, where sepsis was defined as SIRS associated with suspected or proven infection, we have identified the need to assess the prevalence of SIRS and sepsis in children with abnormal temperatures hospitalized in The Children's Clinical University Hospital in Latvia.
Methods:
A descriptive prospective point prevalence study (using two time periods, each 24 h, randomly chosen) was conducted on all children (n = 943) treated in the hospital. All children with abnormal temperatures - fever or hypothermia (n = 92) - were included in the study. Questionnaires evaluating age-specific SIRS criteria were completed. The prevalence of SIRS was detected with 95% CI.
Results:
Out of a total of 943 patients treated in the hospital, 10% (n = 92) had abnormal temperatures. In all these cases the abnormal temperature was a fever; hypothermia was not established in any patient. Of the children with fever, 72% (n = 66) had SIRS. Of the SIRS patients, 8% (n = 5) developed sepsis, 5% (n = 3) severe sepsis and 2% (n = 1) septic shock. Seventy-six percent (n = 50) of the SIRS patients had fever in combination with respiratory rate >2 SD above normal for age; 50% (n = 33) had fever with abnormal leukocyte count; 15% (n = 10) had fever with tachycardia >2 SD above normal for age. Most of the SIRS patients (39%, n = 25) were aged 2-5 years. Twenty-one percent (n = 14) of the children with SIRS and 50% (n = 2) of those with severe sepsis and septic shock had an underlying disease. In no case was SIRS and sepsis recognized by doctors and the diagnoses were not recorded on the patients' cards.
Conclusion:
Our results would indicate a high risk for sepsis development in children with SIRS. Early SIRS diagnosis and awareness of risk of developing sepsis could change the medical approach to the patient in everyday clinical practice, eventually leading to early, goal-directed therapy for sepsis.
