[Detection and initial management of the systemic inflammatory response syndrome in medicine emergency room: 24 hours follow-up in a general hospital].
BACKGROUND
Systemic Inflammatory Response Syndrome (SIRS) is a clinical situation frequently observed in Emergency Room (ER). Its early detection and supporting measures improve prognosis of these patients.


OBJECTIVE
To know the incidence of SIRS among patients who come to ER, their frequency and distribution factors and the clinical evolution at 3 and 30 days.


METHODS
Observational prospective simple-blind study. During 24 hours, SIRS was detected by observant doctors with an independent registry. Their management was observed. Patients from Obstetrics and Traumatology were not observed. Follow-up was done using telephonic and informatical techniques at 3 and 30 day. A descriptive analysis was done.


RESULTS
There were 163 patients attended in ER; 25 of them with SIRS (15.3%), 16 were male (65%) and 9 female (35%). By ages 8 were under 30, 4 were between 30 and 60 and 13 were over. The respiratory rate was not measured in 12 of the 25 patients with SIRS (48%). An infectious etiology (sepsis) was found in 19 of those 25 (76%) patients. The most frequent criterion of sepsis was tachycardia, followed by leukocyte disorders. Support of volume and antimicrobial therapy were only started at once in 21 and 42% respectively on patients with sepsis. 15 of 25 were admitted (2 in ICU). After 3 days, 11 of 25 remained at hospital and after 30 days 2.


CONCLUSIONS
SIRS is a prevalent situation in ER with a high percentage of admissions. Most of SIRS were of infectious origin (sepsis). Major attention is needed among physicians to establish a promptly diagnose and starting support measures that improve their prognosis.
Candel
F J
FJ
Servicio de Microbiología Clínica, Hospital Clínico San Carlos, Madrid, Spain. fj.candel@terra.es
Martínez-Sagasti
F
F
Matesanz
M
M
González Del Castillo
J
J
Ortuño
F
F
Martín
F J
FJ
Moneo
A
A
Candel
I
I