Serial measurements of SIRS and SEP scores to identify unique phenotypes of sepsis

AbstractUsing scoring systems in discreet microbiologic cohorts in a serial fashion to identify unique phenotypes of sepsis remains unknown. Single-center, retrospective study that screened adults who triggered the hospital ’s SIRS (systemic inflammatory response syndrome) based sepsis alert into culture positive (Cx +) and culture negative (Cx−) groups. Subgroups were based on the location where the SIRS alert fired. SIRS scores and a novel score called SEP were calculated att  = 0 and at 3, 6, 12, and 24  h before and aftert  = 0. Primary outcome was a difference in SIRS/SEP scores in Cx  + or Cx− groups over time. Secondary outcomes were differences in total SIRS/SEP scores and the components constituting SIRS/SEP scores at various locations over time. The study contained 7955 patients who met inclusion criteria. Cx + and Cx− groups had increases in SIRS/SEP scores and at similar rates starting 6 hours beforet  = 0. Both culture groups had decreasing SIRS/SEP scores, at varying gradients compared to the change in SIRS/SEP scores seen prior tot  = 0. This pattern in SIRS/SEP scores before and aftert  = 0 was consistent in all location subgroups. Statistically significant differences were seen in the overall SIRS/SEP scores for Cx  + and Cx− groups at hours 6, 12, and 24 aftert  = 0, in the ED group att  = 24  h aftert  = 0, the floor group att  = 0  h, and in the step-down group att  = 3  h aftert  = 0 ...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research