title: Reliability of the identification of the systemic inflammatory response syndrome in critically ill infants and children.
abstract: OBJECTIVE
  To assess interobserver reliability of the identification of episodes of the systemic inflammatory response syndrome in critically ill hospitalized infants and children.
  
  
  METHODS
  Retrospective, cross-sectional study of the application of the 2005 consensus definition of systemic inflammatory response syndrome in infants and children by two independent, trained reviewers using information in the electronic medical record.
  
  
  METHODS
  Eighteen-bed pediatric multidisciplinary medical/surgical pediatric intensive care unit.
  
  
  METHODS
  A randomly selected sample of children admitted consecutively to the pediatric intensive care unit between May 1 and September 30, 2009.
  
  
  METHODS
  None.
  
  
  RESULTS
  Sixty infants and children were selected from a total of 343 admitted patients. Their median age was 3.9 yrs (interquartile range, 1.5-12.7), 57% were female, and 68% were Caucasian. Nineteen (32%) children were identified by both reviewers as having an episode of systemic inflammatory response syndrome (88% agreement, 95% confidence interval 78-94; κ = 0.75, 95% confidence interval 0.59-0.92). Among these 19 children, agreement between the reviewers for individual systemic inflammatory response syndrome criteria was: temperature (84%, 95% confidence interval 60-97); white blood cell count (89%, 95% confidence interval 67-99); respiratory rate (84%, 95% confidence interval 60-97); and heart rate (68%, 95% confidence interval 33-87).
  
  
  CONCLUSIONS
  Episodes of systemic inflammatory response syndrome in critically ill infants and children can be identified reproducibly using the consensus definition.
authors.affiliation: Medical Scientist Training Program, Mayo Graduate School, College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Justin E
authors.initials: JE
authors.lastname: Juskewitch
authors.forename: Swati
authors.initials: S
authors.lastname: Prasad
authors.forename: Carlos F Santillan
authors.initials: CF
authors.lastname: Salas
authors.forename: W Charles
authors.initials: WC
authors.lastname: Huskins
mesh_terms: D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D016638:Critical Illness / Q000401:mortality / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D015588:Observer Variation; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy