Presumed Systemic Inflammatory Response Syndrome in the Pediatric Emergency Department

Area of Science:

• Pediatric Emergency Medicine
• Critical Care
• Infectious Diseases

Background:

• Systemic inflammatory response syndrome (SIRS) and sepsis are critical conditions in children.
• Accurate identification of SIRS and sepsis in the pediatric emergency department (PED) is crucial for timely intervention.

Purpose of the Study:

• To determine the incidence and outcomes of patients presenting with presumed SIRS (pSIRS) in a pediatric emergency department.
• To evaluate the effectiveness of pSIRS criteria in identifying infection and sepsis in pediatric patients.

Main Methods:

• A retrospective cohort study was conducted on pediatric patients (birth to 18 years) presenting to a single-center PED.
• Data were collected over 16 days across one year, identifying patients with pSIRS and sepsis.
• Patient outcomes were followed for one week post-presentation.

Main Results:

• The incidence of pSIRS was 15.3%, with infection present in 76.4% of these patients.
• pSIRS had a sensitivity of 31.4% and specificity of 94.3% for predicting infection.
• Patients with pSIRS had a higher risk of admission (RR 2.4), but 74% were discharged without return visits.

Conclusions:

• Presumed SIRS and sepsis are frequent in the PED.
• Using pSIRS as a sepsis screen may lead to missed infections.
• Current pSIRS definitions may result in over-inclusion of non-severe illnesses.