Systemic inflammatory response syndrome criteria and the prediction of hospital mortality in critically ill patients: a retrospective cohort study

Abstract

ObjectiveThis study intended to determine whether the systemic inflammatory response syndrome criteria can predict hospital mortality in a Brazilian cohort of critically ill patients.MethodsWe performed a retrospective cohort study at a private tertiary hospital in São Paulo (SP), Brazil. We extracted information from the adult intensive care unit database (Sistema Epimed™). We compared the SAPS 3 and the systemic inflammatory response syndrome model as dichotomous (≥ 2 criteria: systemic inflammatory response syndrome -positive versus 0 - 1 criterion: systemic inflammatory response syndrome -negative) and ordinal variables from 0 to 4 (according to the number of systemic inflammatory response syndrome criteria met) in the prediction of hospital mortality at intensive care unit admission. Model discrimination was compared using the area under the receiver operating characteristics (AUROC) curve.ResultsFrom January to December 2012, we studied 932 patients (60.4% were systemic inflammatory response syndrome -positive). systemic inflammatory response syndrome -positive patients were more critically ill than systemic inflammatory response syndrome -negative patients and had higher hospital mortality (16.9% versus 8.1%, p < 0.001). In the adjusted analysis, being systemic inflammatory response syndrome -positive independently increased the risk of death by 82% (odds ratio 1.82; 95% confidence interval [CI] 1.12 - 2.96, p = 0.016). However, the AUROC curve for the SAPS 3 model was higher (0.81, 95%CI 0.78 - 0.85) compared to the systemic inflammatory response syndrome model with the systemic inflammatory response syndrome criteria as a dichotomous variable (0.60, 95%CI 0.55 - 0.65) and as an ordinal variable (0.62, 95%CI 0.57 - 0.68; p < 0.001) for hospital mortality.ConclusionAlthough systemic inflammatory response syndrome is associated with hospital mortality, the systemic inflammatory response syndrome criteria show low accuracy in the prediction of mortality compared with the SAPS 3.

Intestinal tract and parenteral multi-organ sequential pathological injury caused by necrotizing enterocolitis

“…Time-series pathological changes of multiple organ injury induced by NEC Systemic in ammatory response syndrome refers to a kind of uncontrolled systemic in ammatory response caused by various severe infections and noninfectious factors. Further development of systemic in ammatory response syndrome can cause multiple organ dysfunction syndrome [11]. The experimental results showed that the organs of the newborn rats in the NEC group are congested and swollen to varying degrees.…”

Intestinal tract and parenteral multi-organ sequential pathological injury caused by necrotizing enterocolitis

“…SIRS refers to a kind of uncontrolled systemic inflammatory response caused by various severe infections and non-infectious factors. Further development of SIRS can cause MODS [8]. The experimental results showed that the organs of the newborn rats in the observation group are congested and swollen to varying degrees.…”

Intestinal tract and parenteral multi-organ sequential pathological injury caused by necrotizing enterocolitis

“…Time-series pathological changes of multiple organ injury induced by NEC Systemic in ammatory response syndrome refers to a kind of uncontrolled systemic in ammatory response caused by various severe infections and non-infectious factors. Further development of systemic in ammatory response syndrome can cause multiple organ dysfunction syndrome [11]. The experimental results showed that the organs of the newborn rats in the NEC group are congested and swollen to varying degrees.…”