Kiyotsugu takuma 14 , Kazuma Yamakawa 15 & the Japanese Association for Acute Medicine (JAAM) Sepsis prognostication in intensive care Unit and emergency Room (Spice) (JAAM Spice) Study Group* Systemic inflammatory response syndrome (SIRS) reportedly has a low performance for distinguishing infection from non-infection. We explored the distribution of the patients diagnosed by SIRS (SIRS patients) or a quick sequential organ failure assessment (qSOFA) (qSOFA patients) and confirmed the performance of the both for predicting ultimate infection after hospital admission. We retrospectively analyzed the data from a multicenter prospective study. When emergency physicians suspected infection, SIRS or the qSOFA were applied. The area under the receiver operating characteristic curves (AUC) was used to assess the performance of the SIRS and qSOFA for predicting established infection. A total of 1,045 patients were eligible for this study. The SIRS patients accounted for 91.6% of qSOFA patients and they showed a higher rate of final infection than that of non-SIRS patients irrespective of the qSOFA diagnosis. The AUCs for predicting infection with SIRS and a qSOFA were 0.647 and 0.582, respectively. The SIRS significantly predicted an ultimate infection (AUC, 0.675; p = 0.018) in patients who met the SIRS and qSOFA simultaneously. In conclusion, the SIRS patients included almost all qSofA patients. SiRS showed a better performance for predicting infection for qSofA in those who met both definitions. Since the announcement of the third international consensus definitions for sepsis and septic shock (Sepsis-3), much debate has been had on the accuracy of the quick sequential organ failure assessment (qSOFA) score for predicting mortality due to sepsis compared with the systemic inflammatory response syndrome (SIRS)
Initiation of pharyngeal cooling before or immediately after the return of spontaneous circulation is safe and feasible. Pharyngeal cooling can rapidly decrease tympanic temperature without adverse effects on circulation or the pharyngeal epithelium.
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