title: The systemic inflammatory response syndrome (SIRS) to identify infected patients in the emergency room.
abstract: OBJECTIVE
  Evaluation of the usefulness of criteria for systemic inflammatory response syndrome (SIRS) compared with the final diagnosis of infection in patients admitted to the emergency room of two university-based hospitals.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Hospital Universitario San Vicente de Paul and Hospital General de Medellín, Medellín, Colombia. PATIENTS. Seven hundred thirty-four patients with suspected infection as main diagnosis for admittance into the emergency room.
  
  
  RESULTS
  Sensitivity, specificity, predictive values and likelihood ratios (LR) of SIRS criteria at admission were determined using, as gold standards, the diagnosis at the time of discharge based on clinical history and evolution, and microbiological confirmation of infection. SIRS criteria were met by 503 patients (68.5%); the discharge diagnosis of infection was found in 657 (89.4%) and 276 (37%) had microbiological confirmation. SIRS criteria exhibited a sensitivity of 69%, specificity of 35%, positive predictive value (PPV) of 90%, negative predictive value (NPV) of 12% and positive LR of 1.06. There were no differences between the two gold standards.
  
  
  CONCLUSIONS
  The finding of two or more SIRS criteria was of little usefulness for diagnosis of infection. It is necessary to work with new criteria and probably with biological markers, in order to obtain a simple, precise and operative definition of the sepsis phenomenon.
authors.affiliation: School of Medicine, University of Antioquia, Medellin, Colombia. fjaimes@catios.udea.edu.co
authors.forename: Fabián
authors.initials: F
authors.lastname: Jaimes
authors.forename: Jenny
authors.initials: J
authors.lastname: Garcés
authors.forename: Jorge
authors.initials: J
authors.lastname: Cuervo
authors.forename: Federico
authors.initials: F
authors.lastname: Ramírez
authors.forename: Jorge
authors.initials: J
authors.lastname: Ramírez
authors.forename: Andrea
authors.initials: A
authors.lastname: Vargas
authors.forename: Claudia
authors.initials: C
authors.lastname: Quintero
authors.forename: Jorge
authors.initials: J
authors.lastname: Ochoa
authors.forename: Fabio
authors.initials: F
authors.lastname: Tandioy
authors.forename: Láder
authors.initials: L
authors.lastname: Zapata
authors.forename: Juan
authors.initials: J
authors.lastname: Estrada
authors.forename: Maria
authors.initials: M
authors.lastname: Yepes
authors.forename: Hiulber
authors.initials: H
authors.lastname: Leal
mesh_terms: D000328:Adult; D015415:Biomarkers; D015331:Cohort Studies; D004630:Emergencies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007239:Infections / Q000175:diagnosis*; D008137:Longitudinal Studies; D008297:Male; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis*
chemical_list: D015415:Biomarkers