Systemic Inflammatory Response and Progression to Severe Sepsis in Critically Ill Infected Patients

• DOI: 10.1164/rccm.200403-324oc
• Publication Date: 2004-11-06T01:25:22Z
• Authors: Corinne Alberti; Christian Brun-Bu...; Sylvie Chevret; Massimo Antonelli; Sergey V. Goodman; Claudio Martin; Rui Moreno; Ana R. Ochagavia; Mark Palazzo; Karl Werdan; Jean Roger Le Gall
• Keywords: Bacteremia

Rationale: The systemic inflammatory response syndrome has low specificity to identify infected patients at risk of worsening severe sepsis or shock. Objective: To examine the incidence and factors for in patients. Methods: A 1-year inception cohort study 28 intensive care units (n = 1,531) having a first episode infection on admission during stay. Measurements main results: cumulative progression shock was 20% 24% Days 10 30, respectively. Variables independently associated (hazard ratio [HR]) with included: temperature higher than 38.2°C (1.6), heart rate greater 120/minute (1.3), systolic blood pressure 110 mm Hg (1.5), platelets 150 × 109/L serum sodium 145 mmol/L bilirubin 30 μmol/L mechanical ventilation five variables characterizing (pneumonia [HR 1.5], peritonitis [1.5], primary bacteremia [1.8], gram-positive cocci [1.3] aerobic gram-negative bacilli [1.4]). 12 weighted were included score (Risk Infection Severe Sepsis Shock Score, range 0–49), summarized four classes "low" (score 0–8) "moderate" (8.5–16) (9% 17% probability worsening, respectively), "high" (16.5–24) "very high" > 24) (31% 55% probability, respectively). Conclusions: One presenting infection/sepsis worsen estimating this risk, using objectively defined criteria syndrome, could be used by physicians stratify clinical management test new interventions.