The systemic inflammatory response syndrome (SIRS) to identify infected patients in the emergency room.
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.
Jaimes
Fabián
F
School of Medicine, University of Antioquia, Medellin, Colombia. fjaimes@catios.udea.edu.co
Garcés
Jenny
J
Cuervo
Jorge
J
Ramírez
Federico
F
Ramírez
Jorge
J
Vargas
Andrea
A
Quintero
Claudia
C
Ochoa
Jorge
J
Tandioy
Fabio
F
Zapata
Láder
L
Estrada
Juan
J
Yepes
Maria
M
Leal
Hiulber
H
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*
D015415:Biomarkers