title: Utility of the systemic inflammatory response syndrome (SIRS) criteria in predicting the onset of septic shock in hospitalized patients with hematologic malignancies.
abstract: BACKGROUND
  The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM).
  
  
  OBJECTIVE
  To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS).
  
  
  METHODS
  Observational, single-center,nested case-control study.
  
  
  METHODS
  Oncology unit of a tertiary care center.
  
  
  METHODS
  547 consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases.
  
  
  METHODS
  The study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization.
  
  
  RESULTS
  8.4% of subjects developed SS. SIRS scores measured 24 hours prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4,p<0.0001). Using standard SIRS cutpoints, fever, tachypnea and tachycardia were each associated with the onset of SS. Population-specific SIRS criteria were empirically derived.
  
  
  CONCLUSIONS
  Single-center study. Further validation is warranted.
  
  
  CONCLUSIONS
  SIRS can identify HM patients at risk for SS at least 24 hours before SS onset. These data may lead to evidence-based guidelines using routine vital signs to risk-stratify HM patients for SS.
authors: Hematology & Oncology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. anthony.mato@uphs.upenn.edu
authors: Anthony
authors: A
authors: Mato
authors: Barry D
authors: BD
authors: Fuchs
authors: Daniel F
authors: DF
authors: Heitjan
authors: Rosemarie
authors: R
authors: Mick
authors: Scott D
authors: SD
authors: Halpern
authors: Payal D
authors: PD
authors: Shah
authors: Samamtha
authors: S
authors: Jacobs
authors: Erin M
authors: EM
authors: Olson
authors: Stephen J
authors: SJ
authors: Schuster
authors: Chaitra
authors: C
authors: Ujjani
authors: Elise A
authors: EA
authors: Chong
authors: Alison W
authors: AW
authors: Loren
authors: Andrea N
authors: AN
authors: Miltiades
authors: Selina
authors: S
authors: Luger
mesh_terms: D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D012772:Shock, Septic / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis*