Application of SIRS criteria to a paediatric surgical population in Malawi.
BACKGROUND
Little is known regarding systemic inflammatory response syndrome (SIRS) criteria and mortality in developing countries. We evaluated the utility of the SIRS criteria to predict death among a paediatric surgical population in Lilongwe, Malawi.


METHODS
Age, SIRS variables (temperature, heart rate, systolic blood pressure, respiratory rate and leucocyte count), diagnosis, surgical procedure and outcome were analysed for paediatric surgical patients during 2012. Age-specific criteria for SIRS variables were then applied to the data.


RESULTS
Using published SIRS criteria, temperature was the only variable that correlated with mortality. When norms for an African population were used, leucocyte count also correlated with mortality.


CONCLUSIONS
With the exception of temperature, published SIRS criteria were not predictive of mortality. Leucocyte count became predictive of death using norms specific to an African population. SIRS and its component data are a worthwhile area of future prospective research in developing countries.
Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi jcsamuel@med.unc.edu.
Jonathan C
JC
Samuel
Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi.
Carlos
C
Varela
NC Jaycee Burn Center, Department of Surgery, University of North Carolina, Chapel Hill, NC, 27599, USA.
Bruce A
BA
Cairns
Department of Surgery, University of North Carolina, Chapel Hill, NC, 27599, USA.
Anthony G
AG
Charles
D000328:Adult; D002648:Child; D005260:Female; D019983:Guideline Adherence; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008295:Malawi; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013514:Surgical Procedures, Operative; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome; D016896:Treatment Outcome