The Systemic Inflammatory Response Syndrome (SIRS) in acutely hospitalised medical patients: a cohort study
The Systemic Inflammatory Response Syndrome (SIRS) in acutely hospitalised medical patients: a cohort study
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DOI：
10.1186/1757-7241-17-67
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发表时间：
2009-12-27
影响因子：
3.3
通讯作者：
Lassen, Annmarie T.
中科院分区：
文献类型：
--
作者：
Comstedt, Pal;Storgaard, Merete;Lassen, Annmarie T.
背景：脓毒症是一种引起全身炎症反应的感染。临床上，全身炎症反应综合征（SIRS）是由两种或两种以上的症状，包括发热或体温过低，心动过速，呼吸急促和血液白细胞计数的变化。SIRS症状和发病率和死亡率之间的关系在医疗急诊病房patients.Methods：我们进行了一项前瞻性队列研究的频率SIRS及其关系的败血症和死亡急性住院的内科病人。在437例连续患者中，SIRS状态，血压，感染和合并症的入院登记连同28dmortals.Results：154例（35%）有SIRS入院，211例（48%）没有SIRS，72例（16%）有足够的数据来评估他们的SIRS状态。SIRS患者的感染频率高出2.2倍，154名SIRS患者中有66名感染，而211名非SIRS患者中有41名感染：p < 0.001，相对危险度（RR）2.2（95%置信区间（CI）1.6-3.1），他们的28天死亡率是非SIRS患者的6.9倍，154例SIRS患者中有15例，而非SIRS患者中有3例：p = 0.001，RR 6.9（95% CI 2.0-23.3）。SIRS患者中的大多数死亡发生在恶性疾病患者中。感染性休克发生在4/154（3%）的SIRS患者，而这发生在211例患者（0.5%）没有SIRS的到来：p = 0.08，RR 5.5（95%CI 0.6-48.6）。结论：我们发现SIRS状态入院时中度相关的感染和强烈相关的28天死亡率。
Background: Sepsis is an infection which has evoked a systemic inflammatory response. Clinically, the Systemic Inflammatory Response Syndrome (SIRS) is identified by two or more symptoms including fever or hypothermia, tachycardia, tachypnoea and change in blood leucocyte count. The relationship between SIRS symptoms and morbidity and mortality in medical emergency ward patients is unknown.Methods: We conducted a prospective cohort study of the frequency of SIRS and its relationship to sepsis and death among acutely hospitalised medical patients. In 437 consecutive patients, SIRS status, blood pressure, infection and comorbidity on admission was registered together with 28day mortality.Results: A hundred and fifty-four patients (35%) had SIRS on admission, 211 patients (48%) had no SIRS, and 72 patients (16%) had insufficient data to evaluate their SIRS status. SIRS patients were 2.2 times more frequently infected, with 66/154 SIRS patients versus 41/211 non-SIRS patients: p < 0.001, relative risk (RR) 2.2 (95% confidence interval (CI) 1.6-3.1), and they had a 6.9 times higher 28-day mortality than non-SIRS patients with 15/154 SIRS patients versus 3/211 non-SIRS patients: p = 0.001, RR 6.9 (95% CI 2.0-23.3). Most of the deaths among patients with SIRS occurred among patients with malignant conditions. Septic shock developed in 4/154 (3%) of the patients with SIRS, whereas this occurred in only one of the 211 patients (0.5%) without SIRS on arrival: p = 0.08, RR 5.5 (95% CI 0.6-48.6).Conclusion: We found SIRS status on admission to be moderately associated with infection and strongly related to 28-day mortality.