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Clinical Epidemiology of SIRS and Sepsis in Newly Admitted Children
Sheetal Ganjoo1, Kaisar Ahmad, Umar Amin Qureshi
1Department of Pediatrics, GB Pant Hospital Goverment Medical College Associated Hospital, Srinagar, 190011, Kashmir, India.
Insights
Systemic Inflammatory Response Syndrome (SIRS) is prevalent in hospitalized children, with most cases linked to infection. Early recognition and goal-directed treatment of sepsis are crucial to prevent severe outcomes and reduce mortality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Systemic Inflammatory Response Syndrome (SIRS) and sepsis are critical conditions in pediatric hospital admissions.
- Understanding the clinical and demographic profiles of SIRS and sepsis in children is essential for effective management.
Purpose of the Study:
- To assess the clinical and demographic profile of SIRS and sepsis in newly admitted children across different age groups.
- To determine the prevalence and characteristics of SIRS and its progression to sepsis in a North Indian hospital setting.
Main Methods:
- A prospective study involving screening of newly admitted children (0 to <18 years) over randomly selected 24-hour periods.
- Inclusion criteria included abnormal temperature and leukocyte count; diagnosis of SIRS, sepsis, severe sepsis, and septic shock followed international consensus criteria (2002).
Main Results:
- SIRS prevalence was 23% (201/865) among hospitalized children, with 79% having infection-associated SIRS.
- Of SIRS patients, 64% had uncomplicated sepsis, 15% severe sepsis, and 19 of those had septic shock. Organ dysfunction was noted in 25%, with 37.25% having Multiple Organ Dysfunction Syndrome (MODS).
- Pulmonary infections were most common (44%), and Staphylococcus aureus was the most frequent isolate. SIRS patients had significantly longer antibiotic therapy and hospital stays.
Conclusions:
- Sepsis significantly contributes to SIRS in tertiary care settings, highlighting the need for rapid SIRS recognition.
- Goal-directed treatment of sepsis is vital to prevent high mortality associated with severe sepsis and septic shock.
Objective:
To assess the clinical and demographic profile of Systemic Inflammatory Response Syndrome (SIRS) and sepsis, among newly admitted children in different age groups in a hospital in North India.
Methods:
This prospective study was conducted at a referral care centre in Northern India. All children, age group 0 to <18 y, admitted on days selected for study were screened and those with abnormal temperature and abnormal leukocyte count were included for further assessment. A total of twenty "24 h" periods were randomly chosen during the study period. Patients were assessed according to age specific vital signs and laboratory values to diagnose Systemic Inflammatory Response Syndrome (SIRS) and sepsis and to gain clinical and demographic data. The criteria laid at International consensus conference, 2002, were used to define patients as SIRS, Sepsis, Severe sepsis and Septic shock.
Results:
During the study period, a total of 865 patients were screened for SIRS. Prevalence of SIRS amongst hospitalised children was 23 % (n = 201). Seventy nine percent (n = 159) of patients had infection associated SIRS and 21 % (42) had non-infective SIRS. Sixty four percent (n = 129) SIRS patients had uncomplicated sepsis, 15 % (n = 30) patients fulfilled criteria for severe sepsis. Out of the latter 30, 19 had septic shock. Organ dysfunction in SIRS was noted in 25 % (n = 51). 37.25 % (n = 19) had multiple organ dysfunction syndrome (MODS). The most common organism isolated was Staphylococcus aureus (n = 9). Focus of infection in majority was pulmonary (44 %). Mean duration of antibiotic therapy and hospital stay in the SIRS group were 6.4 and 6.5 d respectively. In the group without SIRS, mean duration were 2.44 d and 3.07 d respectively The differences were statistically significant.
Conclusions:
In conclusion, the proportion of sepsis contributing to SIRS is high in a tertiary care hospital. Therefore rapid recognition of SIRS is essential. Goal directed treatment of sepsis is also important so that high mortality associated with severe sepsis and septic shock are prevented.
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