Systemic Inflammatory Response Syndrome Score at Admission Independently Predicts Infection in Blunt Trauma Patients
BACKGROUNDSystemic inflammatory response syndrome (SIRS) score has been demonstrated to be an accurate predictor of outcome in critical surgical illness. To our knowledge, there is a paucity of data using SIRS score as a tool to predict posttraumatic infection. Our goal was to determine whether the...
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| Veröffentlicht in: | The Journal of Trauma: Injury, Infection, and Critical Care Infection, and Critical Care, 2001-05, Vol.50 (5), p.817-820 |
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| container_title | The Journal of Trauma: Injury, Infection, and Critical Care |
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| creator | Bochicchio, Grant V. Napolitano, Lena M. Joshi, Manjari McCarter, Robert J. Scalea, Thomas M. |
| description | BACKGROUNDSystemic inflammatory response syndrome (SIRS) score has been demonstrated to be an accurate predictor of outcome in critical surgical illness. To our knowledge, there is a paucity of data using SIRS score as a tool to predict posttraumatic infection. Our goal was to determine whether the severity of SIRS score at admission is an accurate predictor of infection in trauma patients.
METHODSProspective data were collected on 4,887 blunt trauma patients admitted to a primary adult resource center designated trauma center over an 18-month period. Patients were stratified by age and Injury Severity Score (ISS). SIRS score was calculated at admission. SIRS was defined as an SIRS score ≥ 2. Each patient was screened for infection by an infectious disease specialist. Those at high risk for infection were then monitored daily throughout their hospitalization. Centers for Disease Control and Prevention guidelines were used to diagnose infection.
RESULTSOf the 4,887 patients, 1,850 (38%) were admitted > 24 hours and evaluated for subsequent infection (mean ISS, 16 ± 9; mean age, 43 ± 19, SD). Thirty-one percent (577) of the patients acquired an infection. The mean hospital length of stay (20.2 days vs. 6.5 days) and mortality (7.8% vs. 2.7%) were significantly greater in the infected group (p < 0.001). Of the four SIRS variables (temperature, heart rate, white blood cell count, and respiratory rate), hypothermia and leukocytosis were the most significant predictors of infection (p < 0.001) when adjusted for age and ISS. SIRS scores of ≥ 2 were increasingly predictive of infection when analyzed by multiple logistic regression analysis.
CONCLUSIONAn admission SIRS score of ≥ 2 is a significant independent predictor of infection and outcome in blunt trauma. Daily SIRS scores may be a meaningful method of assessing postinjury risk of infection, and may initiate earlier diagnostic intervention for determination of infection. |
| doi_str_mv | 10.1097/00005373-200105000-00007 |
| format | Article |
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METHODSProspective data were collected on 4,887 blunt trauma patients admitted to a primary adult resource center designated trauma center over an 18-month period. Patients were stratified by age and Injury Severity Score (ISS). SIRS score was calculated at admission. SIRS was defined as an SIRS score ≥ 2. Each patient was screened for infection by an infectious disease specialist. Those at high risk for infection were then monitored daily throughout their hospitalization. Centers for Disease Control and Prevention guidelines were used to diagnose infection.
RESULTSOf the 4,887 patients, 1,850 (38%) were admitted > 24 hours and evaluated for subsequent infection (mean ISS, 16 ± 9; mean age, 43 ± 19, SD). Thirty-one percent (577) of the patients acquired an infection. The mean hospital length of stay (20.2 days vs. 6.5 days) and mortality (7.8% vs. 2.7%) were significantly greater in the infected group (p < 0.001). Of the four SIRS variables (temperature, heart rate, white blood cell count, and respiratory rate), hypothermia and leukocytosis were the most significant predictors of infection (p < 0.001) when adjusted for age and ISS. SIRS scores of ≥ 2 were increasingly predictive of infection when analyzed by multiple logistic regression analysis.
CONCLUSIONAn admission SIRS score of ≥ 2 is a significant independent predictor of infection and outcome in blunt trauma. Daily SIRS scores may be a meaningful method of assessing postinjury risk of infection, and may initiate earlier diagnostic intervention for determination of infection.</description><identifier>ISSN: 0022-5282</identifier><identifier>EISSN: 1529-8809</identifier><identifier>DOI: 10.1097/00005373-200105000-00007</identifier><identifier>PMID: 11379594</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Emergency and intensive care: injuries, diseases due to physical agents. Diving. Drowning. Disaster medicine ; Female ; Humans ; Injury Severity Score ; Intensive care medicine ; Length of Stay ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Risk Assessment ; Systemic Inflammatory Response Syndrome ; Treatment Outcome ; Wounds, Nonpenetrating - complications</subject><ispartof>The Journal of Trauma: Injury, Infection, and Critical Care, 2001-05, Vol.50 (5), p.817-820</ispartof><rights>2001 Lippincott Williams & Wilkins, Inc.</rights><rights>2001 INIST-CNRS</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4517-8af30ad9b000bfcf16a9e62f2f5fdaad102021e2225969512a863a63789291943</citedby><cites>FETCH-LOGICAL-c4517-8af30ad9b000bfcf16a9e62f2f5fdaad102021e2225969512a863a63789291943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,777,781,786,787,23911,23912,25121,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1057985$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11379594$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bochicchio, Grant V.</creatorcontrib><creatorcontrib>Napolitano, Lena M.</creatorcontrib><creatorcontrib>Joshi, Manjari</creatorcontrib><creatorcontrib>McCarter, Robert J.</creatorcontrib><creatorcontrib>Scalea, Thomas M.</creatorcontrib><title>Systemic Inflammatory Response Syndrome Score at Admission Independently Predicts Infection in Blunt Trauma Patients</title><title>The Journal of Trauma: Injury, Infection, and Critical Care</title><addtitle>J Trauma</addtitle><description>BACKGROUNDSystemic inflammatory response syndrome (SIRS) score has been demonstrated to be an accurate predictor of outcome in critical surgical illness. To our knowledge, there is a paucity of data using SIRS score as a tool to predict posttraumatic infection. Our goal was to determine whether the severity of SIRS score at admission is an accurate predictor of infection in trauma patients.
METHODSProspective data were collected on 4,887 blunt trauma patients admitted to a primary adult resource center designated trauma center over an 18-month period. Patients were stratified by age and Injury Severity Score (ISS). SIRS score was calculated at admission. SIRS was defined as an SIRS score ≥ 2. Each patient was screened for infection by an infectious disease specialist. Those at high risk for infection were then monitored daily throughout their hospitalization. Centers for Disease Control and Prevention guidelines were used to diagnose infection.
RESULTSOf the 4,887 patients, 1,850 (38%) were admitted > 24 hours and evaluated for subsequent infection (mean ISS, 16 ± 9; mean age, 43 ± 19, SD). Thirty-one percent (577) of the patients acquired an infection. The mean hospital length of stay (20.2 days vs. 6.5 days) and mortality (7.8% vs. 2.7%) were significantly greater in the infected group (p < 0.001). Of the four SIRS variables (temperature, heart rate, white blood cell count, and respiratory rate), hypothermia and leukocytosis were the most significant predictors of infection (p < 0.001) when adjusted for age and ISS. SIRS scores of ≥ 2 were increasingly predictive of infection when analyzed by multiple logistic regression analysis.
CONCLUSIONAn admission SIRS score of ≥ 2 is a significant independent predictor of infection and outcome in blunt trauma. Daily SIRS scores may be a meaningful method of assessing postinjury risk of infection, and may initiate earlier diagnostic intervention for determination of infection.</description><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Emergency and intensive care: injuries, diseases due to physical agents. Diving. Drowning. Disaster medicine</subject><subject>Female</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Intensive care medicine</subject><subject>Length of Stay</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Risk Assessment</subject><subject>Systemic Inflammatory Response Syndrome</subject><subject>Treatment Outcome</subject><subject>Wounds, Nonpenetrating - complications</subject><issn>0022-5282</issn><issn>1529-8809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1v1DAQhi1ERVdt_wLyAXEL-GMd28dSUahUiYq2Z2vWGasRTrLYjqr8e5zu8nHBB3s8et6Z0TuEUM4-cGb1R1aPklo2gjHOVP01a0q_IhuuhG2MYfY12TAmRKOEEafkIud-VxGhtBXmDTnlXGqr7HZDyv2SCw69pzdjiDAMUKa00O-Y99OYkd4vY5emoQZ-Skih0Mtu6Gu9aayKDvdYr7HEhd4l7Hpf8loIfVmBfqSf4jwW-pBgHoDeQekrnM_JSYCY8eL4npHH688PV1-b229fbq4ubxu_VVw3BoJk0Nl19F3wgbdgsRVBBBU6gI4zwQRHIYSyrVVcgGkltFIbKyy3W3lG3h_q7tP0c8ZcXB3dY4ww4jRnp5nRRktbQXMAfZpyThjcPvUDpMVx5lbT3W_T3R_TX1K6St8ee8y7Abu_wqPFFXh3BCB7iCHB6Pv8T4O6FKMqtj1gz1MsmPKPOD9jck8IsTy5_-1c_gLd5pm8</recordid><startdate>200105</startdate><enddate>200105</enddate><creator>Bochicchio, Grant V.</creator><creator>Napolitano, Lena M.</creator><creator>Joshi, Manjari</creator><creator>McCarter, Robert J.</creator><creator>Scalea, Thomas M.</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200105</creationdate><title>Systemic Inflammatory Response Syndrome Score at Admission Independently Predicts Infection in Blunt Trauma Patients</title><author>Bochicchio, Grant V. ; Napolitano, Lena M. ; Joshi, Manjari ; McCarter, Robert J. ; Scalea, Thomas M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4517-8af30ad9b000bfcf16a9e62f2f5fdaad102021e2225969512a863a63789291943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Emergency and intensive care: injuries, diseases due to physical agents. Diving. Drowning. Disaster medicine</topic><topic>Female</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Intensive care medicine</topic><topic>Length of Stay</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Risk Assessment</topic><topic>Systemic Inflammatory Response Syndrome</topic><topic>Treatment Outcome</topic><topic>Wounds, Nonpenetrating - complications</topic><toplevel>online_resources</toplevel><creatorcontrib>Bochicchio, Grant V.</creatorcontrib><creatorcontrib>Napolitano, Lena M.</creatorcontrib><creatorcontrib>Joshi, Manjari</creatorcontrib><creatorcontrib>McCarter, Robert J.</creatorcontrib><creatorcontrib>Scalea, Thomas M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of Trauma: Injury, Infection, and Critical Care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bochicchio, Grant V.</au><au>Napolitano, Lena M.</au><au>Joshi, Manjari</au><au>McCarter, Robert J.</au><au>Scalea, Thomas M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systemic Inflammatory Response Syndrome Score at Admission Independently Predicts Infection in Blunt Trauma Patients</atitle><jtitle>The Journal of Trauma: Injury, Infection, and Critical Care</jtitle><addtitle>J Trauma</addtitle><date>2001-05</date><risdate>2001</risdate><volume>50</volume><issue>5</issue><spage>817</spage><epage>820</epage><pages>817-820</pages><issn>0022-5282</issn><eissn>1529-8809</eissn><abstract>BACKGROUNDSystemic inflammatory response syndrome (SIRS) score has been demonstrated to be an accurate predictor of outcome in critical surgical illness. To our knowledge, there is a paucity of data using SIRS score as a tool to predict posttraumatic infection. Our goal was to determine whether the severity of SIRS score at admission is an accurate predictor of infection in trauma patients.
METHODSProspective data were collected on 4,887 blunt trauma patients admitted to a primary adult resource center designated trauma center over an 18-month period. Patients were stratified by age and Injury Severity Score (ISS). SIRS score was calculated at admission. SIRS was defined as an SIRS score ≥ 2. Each patient was screened for infection by an infectious disease specialist. Those at high risk for infection were then monitored daily throughout their hospitalization. Centers for Disease Control and Prevention guidelines were used to diagnose infection.
RESULTSOf the 4,887 patients, 1,850 (38%) were admitted > 24 hours and evaluated for subsequent infection (mean ISS, 16 ± 9; mean age, 43 ± 19, SD). Thirty-one percent (577) of the patients acquired an infection. The mean hospital length of stay (20.2 days vs. 6.5 days) and mortality (7.8% vs. 2.7%) were significantly greater in the infected group (p < 0.001). Of the four SIRS variables (temperature, heart rate, white blood cell count, and respiratory rate), hypothermia and leukocytosis were the most significant predictors of infection (p < 0.001) when adjusted for age and ISS. SIRS scores of ≥ 2 were increasingly predictive of infection when analyzed by multiple logistic regression analysis.
CONCLUSIONAn admission SIRS score of ≥ 2 is a significant independent predictor of infection and outcome in blunt trauma. Daily SIRS scores may be a meaningful method of assessing postinjury risk of infection, and may initiate earlier diagnostic intervention for determination of infection.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>11379594</pmid><doi>10.1097/00005373-200105000-00007</doi><tpages>4</tpages></addata></record> |
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| subjects | Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Emergency and intensive care: injuries, diseases due to physical agents. Diving. Drowning. Disaster medicine Female Humans Injury Severity Score Intensive care medicine Length of Stay Logistic Models Male Medical sciences Middle Aged Predictive Value of Tests Prognosis Risk Assessment Systemic Inflammatory Response Syndrome Treatment Outcome Wounds, Nonpenetrating - complications |
| title | Systemic Inflammatory Response Syndrome Score at Admission Independently Predicts Infection in Blunt Trauma Patients |
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