| The systemic inflammatory response syndrome as a predictor of bacteraemia and outcome from sepsis. | |
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MedLine Citation:
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PMID: 8759492 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Criteria defining the systemic inflammatory response syndrome (SIRS) were used to assess prospectively 270 clinical episodes in which blood cultures were taken from patients in general medicine. SIRS, severe sepsis and septic shock occurred in 149 (55%), 13 (5%) and 9 (3%) episodes, respectively. However, evidence of organ hypoperfusion indicating severe sepsis was recorded as sought in only 26% of episodes of SIRS. Crude mortality at 28 days increased sequentially as more SIRS criteria were met, rising from 12% in non-SIRS blood culture episodes, to 36% when all four criteria were met. Mortality from severe sepsis and septic shock was 38% and 56%, respectively. In 61/64 (95%) episodes of clinically important bacteraemia, patients fulfilled SIRS criteria when the blood culture was taken. However, the positive predictive value of SIRS for predicting bacteraemia was only 7%. Patients who did not fulfil SIRS criteria when blood cultures were taken were at low risk of bacteraemia and comprised 45% (121/270) of the study population. Three patients in this low-risk group had bacteraemia. Mortality in bacteraemic patients with severe sepsis or septic shock who were initially treated with ineffective antibiotics for up to 48 h was 80%, compared to 42% in those always treated appropriately. |
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Authors:
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G R Jones; J A Lowes |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: QJM : monthly journal of the Association of Physicians Volume: 89 ISSN: 1460-2725 ISO Abbreviation: QJM Publication Date: 1996 Jul |
Date Detail:
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Created Date: 1996-09-30 Completed Date: 1996-09-30 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9438285 Medline TA: QJM Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 515-22 Citation Subset: IM |
Affiliation:
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Public Health Laboratory, Southampton General Hospital, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents / therapeutic use Bacteremia / diagnosis, drug therapy, mortality Female Humans Male Middle Aged Predictive Value of Tests Prospective Studies Sepsis / diagnosis, mortality, prevention & control Shock, Septic / diagnosis, mortality, prevention & control Systemic Inflammatory Response Syndrome / diagnosis*, drug therapy, mortality Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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