Does severe non-infectious SIRS differ from severe sepsis? Results from a multi-centre Australian and New Zealand intensive care unit study

Dulhunty, Joel M., Lipman, Jeffrey and Finfer, Simon (2008) Does severe non-infectious SIRS differ from severe sepsis? Results from a multi-centre Australian and New Zealand intensive care unit study. Intensive Care Medicine, 34 9: 1654-1661. doi:10.1007/s00134-008-1160-2


Author Dulhunty, Joel M.
Lipman, Jeffrey
Finfer, Simon
Title Does severe non-infectious SIRS differ from severe sepsis? Results from a multi-centre Australian and New Zealand intensive care unit study
Journal name Intensive Care Medicine   Check publisher's open access policy
ISSN 0342-4642
1432-1238
Publication date 2008-09-01
Year available 2008
Sub-type Article (original research)
DOI 10.1007/s00134-008-1160-2
Open Access Status Not Open Access
Volume 34
Issue 9
Start page 1654
End page 1661
Total pages 8
Editor Massimo Antonelli
Place of publication Germany
Publisher Springer-Verlag
Language eng
Subject C1
920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
110310 Intensive Care
Abstract Objective To compare the time course of organ dysfunction/failure, mortality and cause of death in patients with severe sepsis (SS) and patients with severe non-infectious systemic inflammatory response syndrome (SNISIRS). Design Secondary analysis of a multi-centre inception cohort study. Setting Twenty-three multidisciplinary intensive care units (ICUs) in Australia and New Zealand. Patients and participants 3,543 ICU admissions ≥48 h or <48 h if SIRS and organ dysfunction present. Interventions None. Measurements and results ICU prevalence of SS and SNISIRS was 20% (707/3,543) and 28% (980/3,543), respectively. ICU mortality was similar in patients with SNISIRS and with SS (25 vs. 27%, P = 0.40). Central nervous system (CNS) failure occurred more frequently in patients with SNISIRS (33 vs. 22%, P < 0.001) and resulted in death more commonly than in SS (relative risk = 1.6, 95% confidence interval 1.4–1.7, P < 0.001). The time to peak organ dysfunction (0.67 vs. 0.91 days, P = 0.004), overall episode length (3.6 vs. 5.6 days, P < 0.001) and ICU stay (geometric mean: 4.1 vs. 5.8 days, P < 0.001) were significantly shorter in patients with SNISIRS. Conclusions Whilst SNISIRS and SS have similarities, including their crude mortality rate, important differences exist. SNISIRS is more common on admission to the ICU, and is more commonly coupled with CNS dysfunction and death from neurological failure. Descriptors SIRS/sepsis: clinical studies.
Keyword Sepsis
Severe Sepsis
SIRS
epidemiology
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Thu, 16 Apr 2009, 01:20:02 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH