Systemic Inflammatory Response Syndrome Criteria in Defining Severe Sepsis
Systemic Inflammatory Response Syndrome Criteria in Defining Severe Sepsis
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全身炎症反应综合征标准在定义严重脓毒症中的应用
DOI：
10.1056/nejmoa1415236
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发表时间：
2015-04-23
影响因子：
158.5
通讯作者：
Bellomo, Rinaldo
中科院分区：
文献类型：
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作者：
Kaukonen, Kirsi-Maija;Bailey, Michael;Bellomo, Rinaldo
严重脓毒症的共识定义需要怀疑或证实感染、器官衰竭和符合两个或多个全身炎症反应综合征（SIRS）标准的体征。我们的目的是测试的敏感性，表面效度，结构效度的这种approach. METHODS我们研究了从2000年到2013年在澳大利亚和新西兰的172重症监护病房的患者的数据。我们确定了感染和器官衰竭的患者，并根据他们是否有符合两个或更多SIRS标准（SIRS阳性严重脓毒症）或少于两个SIRS标准（SIRS阴性严重脓毒症）的体征对其进行分类。我们比较了他们的特征和结果，并评估了他们在两个SIRS标准的阈值下死亡风险的逐步增加。在1，171，797例患者中，共有109，663例感染和器官衰竭。其中，96，385例患者（87.9%）患有SIRS阳性严重脓毒症，13，278例患者（12.1%）患有SIRS阴性严重脓毒症。在14年的时间里，这些组具有相似的特征和死亡率的变化（SIRS阳性组：从36.1% [2296例患者中的829例]到18.3% [11,119例患者中的2037例]，P
BACKGROUNDThe consensus definition of severe sepsis requires suspected or proven infection, organ failure, and signs that meet two or more criteria for the systemic inflammatory response syndrome (SIRS). We aimed to test the sensitivity, face validity, and construct validity of this approach.METHODSWe studied data from patients from 172 intensive care units in Australia and New Zealand from 2000 through 2013. We identified patients with infection and organ failure and categorized them according to whether they had signs meeting two or more SIRS criteria (SIRS-positive severe sepsis) or less than two SIRS criteria (SIRS-negative severe sepsis). We compared their characteristics and outcomes and assessed them for the presence of a step increase in the risk of death at a threshold of two SIRS criteria.RESULTSOf 1,171,797 patients, a total of 109,663 had infection and organ failure. Among these, 96,385 patients (87.9%) had SIRS-positive severe sepsis and 13,278 (12.1%) had SIRS-negative severe sepsis. Over a period of 14 years, these groups had similar characteristics and changes in mortality (SIRS-positive group: from 36.1% [829 of 2296 patients] to 18.3% [2037 of 11,119], P