title: Systemic inflammatory response syndrome in tissue-type plasminogen activator-treated patients is associated with worse short-term functional outcome.
abstract: OBJECTIVE
  Systemic inflammatory response syndrome (SIRS) is a generalized inflammatory state. The primary goal of the study was to determine whether differences exist in outcomes in SIRS and non-SIRS intravenous tissue-type plasminogen activator-treated patients.
  
  
  METHODS
  Consecutive patients were retrospectively reviewed for the evidence of SIRS during their admission. SIRS was defined as the presence of ≥2 of the following: body temperature<36°C or >38°C, heart rate>90, respiratory rate>20, and white blood cells<4000/mm or >12 000 mm, or >10% bands. Patients diagnosed with infection (via positive culture) were excluded.
  
  
  RESULTS
  Of the 241 patients, 44 had evidence of SIRS (18%). Adjusting for pre-tissue-type plasminogen activator National Institutes of Health Stroke Scale, age, and race, SIRS remained a predictor of poor functional outcome at discharge (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.16-5.73; P=0.0197).
  
  
  CONCLUSIONS
  In our sample of tissue-type plasminogen activator-treated (tPA) patients, ~1 in 5 patients developed SIRS. Furthermore, we found the presence of SIRS to be associated with poor short-term functional outcomes and prolonged length of stay.
authors.affiliation: Stroke Center, Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294-6810, USA.
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Boehme
authors.forename: Niren
authors.initials: N
authors.lastname: Kapoor
authors.forename: Karen C
authors.initials: KC
authors.lastname: Albright
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lyerly
authors.forename: Pawan V
authors.initials: PV
authors.lastname: Rawal
authors.forename: R
authors.initials: R
authors.lastname: Bavarsad Shahripour
authors.forename: Reza Bavarsad
authors.initials: RB
authors.lastname: Shahripour
authors.forename: Muhammad
authors.initials: M
authors.lastname: Alvi
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Houston
authors.forename: April
authors.initials: A
authors.lastname: Sisson
authors.forename: T Mark
authors.initials: TM
authors.lastname: Beasley
authors.forename: Anne W
authors.initials: AW
authors.lastname: Alexandrov
authors.forename: Andrei V
authors.initials: AV
authors.lastname: Alexandrov
authors.forename: David W
authors.initials: DW
authors.lastname: Miller
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology* / Q000401:mortality; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: inflammation; ischemic stroke; stroke care; tPA