How many general and inflammatory variables need to be fulfilled when defining sepsis due to the 2003 SCCM/ESICM/ACCP/ATS/SIS definitions in critically ill surgical patients: a retrospective observational study

BMC Anesthesiology

Research Article

Michael Taenzer¹  Moritz Huber¹  Manfred Weiss¹  Maximilian Nass¹  Marion Schneider²  Markus Huber-Lang³  Birgit Hay⁴  Martina Kron⁴ 

[1] Department of Anaesthesiology, University Hospital Medical School Ulm, Steinhoevelstr. 9, 89075, Ulm, Germany;Department of Experimental Anaesthesiology, University Hospital Medical School Ulm, Steinhoevelstr. 9, 89075, Ulm, Germany;Department of Traumatology, Hand-, Plastic-, and Reconstructive Surgery, University Hospital Medical School Ulm, Steinhoevelstr. 9, 89075, Ulm, Germany;Institute of Epidemiology and Medical Biometry, University of Ulm, Schwabstr. 13, 89075, Ulm, Germany;

关键词: Septic Shock;    Severe Sepsis;    Organ Dysfunction;    Systemic Inflammatory Response Syndrome;    Sequential Organ Failure Assessment Score;   

DOI  :  10.1186/1471-2253-10-22

 received in 2009-11-09, accepted in 2010-12-21,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundIt has never been specified how many of the extended general and inflammatory variables of the 2003 SCCM/ESICM/ACCP/ATS/SIS consensus sepsis definitions are mandatory to define sepsis.ObjectivesTo find out how many of these variables are needed to identify almost all patients with septic shock.MethodsRetrospective observational single-centre study in postoperative/posttraumatic patients admitted to an University adult ICU. The survey looked at 1355 admissions, from 01/2007 to 12/2008, that were monitored daily computer-assisted for the eight general and inflammatory variables temperature, heart rate, respiratory rate, significant edema, positive fluid balance, hyperglycemia, white blood cell count and C-reactive protein. A total of 507 patients with infections were classified based on the first day with the highest diagnostic category of sepsis during their stay using a cut-off of 1/8 variables compared with the corresponding classification based on a cut-off of 2, 3, 4, 5, 6, 7 or 8/8 variables.ResultsApplying cut-offs of 1/8 up to 8/8 variables resulted in a decreased detection rate of cases with septic shock, i.e., from 106, 105, 103, 93, 65, 21, 3 to 0. The mortality rate increased up to a cut-off of 6/8 variables, i.e., 31% (33/106), 31% (33/105), 31% (32/103), 32% (30/93), 38% (25/65), 43% (9/21), 33% (1/3) and 0% (0/0).ConclusionsFrequencies and mortality rates of diagnostic categories of sepsis differ depending on the cut-off for general and inflammatory variables. A cut-off of 3/8 variables is needed to identify almost all patients with septic shock who may benefit from optimal treatment.

【 授权许可】

CC BY   
© Weiss et al; licensee BioMed Central Ltd. 2010