title: Incidence and Prognostic Value of the Systemic Inflammatory Response Syndrome and Organ Dysfunctions in Ward Patients.
abstract: BACKGROUND
  Tools that screen inpatients for sepsis use the systemic inflammatory response syndrome (SIRS) criteria and organ dysfunctions, but most studies of these criteria were performed in intensive care unit or emergency room populations.
  
  
  OBJECTIVE
  To determine the incidence and prognostic value of SIRS and organ dysfunctions in a multicenter dataset of hospitalized ward patients.
  
  
  METHODS
  Hospitalized ward patients at five hospitals from November 2008 to January 2013 were included. SIRS and organ system dysfunctions were defined using 2001 International Consensus criteria. Patient characteristics and in-hospital mortality were compared among patients meeting two or more SIRS criteria and by the presence or absence of organ system dysfunction.
  
  
  RESULTS
  A total of 269,951 patients were included in the study, after excluding 48 patients with missing discharge status. Forty-seven percent (n = 125,841) of the included patients met two or more SIRS criteria at least once during their ward stay. On ward admission, 39,105 (14.5%) patients met two or more SIRS criteria, and patients presenting with SIRS had higher in-hospital mortality than those without SIRS (4.3% vs. 1.2%; P < 0.001). Fourteen percent of patients (n = 36,767) had at least one organ dysfunction at ward admission, and those presenting with organ dysfunction had increased mortality compared with those without organ dysfunction (5.3% vs. 1.1%; P < 0.001).
  
  
  CONCLUSIONS
  Almost half of patients hospitalized on the wards developed SIRS at least once during their ward stay. Our findings suggest that screening ward patients using SIRS criteria for identifying those with sepsis would be impractical.
authors.affiliation: 1 Department of Medicine, University of Chicago, Chicago, Illinois; and.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Churpek
authors.affiliation: 1 Department of Medicine, University of Chicago, Chicago, Illinois; and.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Zadravecz
authors.affiliation: 2 Department of Medicine, NorthShore University HealthSystem, Evanston, Illinois.
authors.forename: Christopher
authors.initials: C
authors.lastname: Winslow
authors.affiliation: 1 Department of Medicine, University of Chicago, Chicago, Illinois; and.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Howell
authors.affiliation: 1 Department of Medicine, University of Chicago, Chicago, Illinois; and.
authors.forename: Dana P
authors.initials: DP
authors.lastname: Edelson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature; D016208:Databases, Factual; D005260:Female; D006339:Heart Rate; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D007958:Leukocyte Count; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000453:epidemiology*; D010362:Patients' Rooms; D010976:Platelet Count; D011379:Prognosis; D056152:Respiratory Rate; D018805:Sepsis / Q000175:diagnosis*; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000453:epidemiology*
keywords: multiple organ failure; organ dysfunction scores; sepsis; systemic inflammatory response syndrome