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Title: Persistent Systemic Inflammatory Response Syndrome Scores Accurately Predict Nosocomial Infection and Outcome

URL: http://ipsapp003.lwwonline.com/content/getfile/2281/96/10/abstract.htm

Journal of Trauma,Injury,Infection and Critical Care 2002 Vol 53 pp245-251 "Persistent Systemic Inflammatory Response Syndrome Is Predictive of Nosocomial Infection in Trauma"
09/03/2002 01:35:58 PM
By Veronica Rose

The systemic inflammatory response syndrome (SIRS) score appears to be an accurate predictor of nosocomial infection and outcome in trauma. The finding suggests the need for early clinical intervention to identify the source of infection, and consideration of antimicrobial therapy. Most previous reports have been limited to studying the value of only one SIRS score at admission. But one study in a surgical intensive care unit reported a decline on day two after resuscitation was complete, suggesting that a SIRS score at this point might be a more accurate predictor of outcome. Consequently researchers at the University of Maryland School of Medicine, Baltimore, Maryland, United States, collected data on 702 consecutive patients admitted to the intensive care unit over a period of 12 months. SIRS scores were calculated daily with the object of determining their value in predicting nosocomial infection and the outcome of patients at high risk. They used guidelines laid down for the diagnosis of infection by the Centers for Disease Control and Prevention; statistical analysis was undertaken by multivariate linear regression. The causative factor in trauma was blunt injury in 573 patients (82 percent), and sustained penetrating injuries in 129 (18 percent). The mean age of patients was 43 years, with an overall mortality of 11.4 percent. A nosocomial infection developed in 290 (41.3 percent) of the patients being studied, with an associated mortality rate of 12.4 percent. The most common site of infection was respiratory. The researchers found that a SIRS score of two or more on hospital days three through seven proved a significant predictor of nosocomial infection and the length of hospitalisation. A significant risk for increased mortality was seen in patients whose SIRS score was two or more persistently through hospital day seven.

http://ipsapp003.lwwonline.com/content/getfile/2281/96/10/abstract.htm

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