Utility of the systemic inflammatory response syndrome (SIRS) criteria in predicting the onset of septic shock in hospitalized patients with hematologic malignancies
Background: The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM). Objective: To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS). Design: Obs...
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| Published in | Cancer biology & therapy Vol. 8; no. 12; pp. 1095 - 1100 |
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| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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United States
Taylor & Francis
15.06.2009
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| Abstract | Background: The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM). Objective: To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS). Design: Observational, single-center, nested case-control study. Setting: Oncology unit of a tertiary care center. Patients: 547 consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases. Measurements: The study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization. Main Results: 8.4% of subjects developed SS. SIRS scores measured 24 hours prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4, p |
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| AbstractList | The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM).
To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS).
Observational, single-center,nested case-control study.
Oncology unit of a tertiary care center.
547 consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases.
The study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization.
8.4% of subjects developed SS. SIRS scores measured 24 hours prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4,p<0.0001). Using standard SIRS cutpoints, fever, tachypnea and tachycardia were each associated with the onset of SS. Population-specific SIRS criteria were empirically derived.
Single-center study. Further validation is warranted.
SIRS can identify HM patients at risk for SS at least 24 hours before SS onset. These data may lead to evidence-based guidelines using routine vital signs to risk-stratify HM patients for SS. The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM).BACKGROUNDThe systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM).To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS).OBJECTIVETo determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS).Observational, single-center,nested case-control study.DESIGNObservational, single-center,nested case-control study.Oncology unit of a tertiary care center.SETTINGOncology unit of a tertiary care center.547 consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases.PATIENTS547 consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases.The study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization.MEASUREMENTSThe study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization.8.4% of subjects developed SS. SIRS scores measured 24 hours prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4,p<0.0001). Using standard SIRS cutpoints, fever, tachypnea and tachycardia were each associated with the onset of SS. Population-specific SIRS criteria were empirically derived.MAIN RESULTS8.4% of subjects developed SS. SIRS scores measured 24 hours prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4,p<0.0001). Using standard SIRS cutpoints, fever, tachypnea and tachycardia were each associated with the onset of SS. Population-specific SIRS criteria were empirically derived.Single-center study. Further validation is warranted.LIMITATIONSSingle-center study. Further validation is warranted.SIRS can identify HM patients at risk for SS at least 24 hours before SS onset. These data may lead to evidence-based guidelines using routine vital signs to risk-stratify HM patients for SS.CONCLUSIONSSIRS can identify HM patients at risk for SS at least 24 hours before SS onset. These data may lead to evidence-based guidelines using routine vital signs to risk-stratify HM patients for SS. Background: The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM). Objective: To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS). Design: Observational, single-center, nested case-control study. Setting: Oncology unit of a tertiary care center. Patients: 547 consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases. Measurements: The study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization. Main Results: 8.4% of subjects developed SS. SIRS scores measured 24 hours prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4, p Background: The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM). Objective: To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS). Design: Observational, single-center, nested case-control study. Setting: Oncology unit of a tertiary care center. Patients: 547 consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases. Measurements: The study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization. Main Results: 8.4% of subjects developed SS. SIRS scores measured 24 hours prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4, p<0.0001). Using standard SIRS cutpoints, fever, tachypnea and tachycardia were each associated with the onset of SS. Population-specific SIRS criteria were empirically derived. Limitations: Single-center study. Further validation is warranted. Conclusions: SIRS can identify HM patients at risk for SS at least 24 hours before SS onset. These data may lead to evidence-based guidelines using routine vital signs to risk-stratify HM patients for SS. |
| Author | Miltiades, Andrea N. Shah, Payal D. Loren, Alison W. Luger, Selina Mato, Anthony Chong, Elise A. Fuchs, Barry D. Olson, Erin M. Mick, Rosemarie Halpern, Scott D. Schuster, Stephen J. Ujjani, Chaitra F. Heitjan, Daniel Jacobs, Samantha |
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| Snippet | Background: The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM). Objective: To... The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM). To determine whether daily... The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM).BACKGROUNDThe systemic... |
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| SubjectTerms | Binding Biology Bioscience Calcium Cancer Case-Control Studies Cell Cohort Studies Cycle Female Hematologic Neoplasms - complications Humans Landes Male Middle Aged Multivariate Analysis Organogenesis Proteins ROC Curve Shock, Septic - blood Shock, Septic - diagnosis Shock, Septic - prevention & control Systemic Inflammatory Response Syndrome - diagnosis |
| Title | Utility of the systemic inflammatory response syndrome (SIRS) criteria in predicting the onset of septic shock in hospitalized patients with hematologic malignancies |
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