![]() ![]() SIRS can arise due to various causes and includes, but is not limited to, more than one of the following four clinical manifestations ( 7): tachycardia (TC), tachypnea (TP), abnormal body temperature (Tem), and abnormal leukocyte (while blood cell) count (Leu). SIRS remains an important predictor of sepsis ( 11) and is still a relevant topic of current research, see, e.g., ( 12), ( 13), or ( 14). However, this is controversially discussed, especially as Sepsis-3 has been developed as epidemiological measure of sepsis incidence rather than to support early detection of sepsis ( 10). In particular, Sepsis-3 is not based on the SIRS concept anymore. In contrast, the latest consensus definition of sepsis, commonly referred to as Sepsis-3, specifies sepsis as a life-threatening organ dysfunction, caused by a dysregulated host response to an infection ( 8, 9). Sepsis originally had been defined as the systemic inflammatory response syndrome (SIRS) due to an infection ( 7), commonly referred to as Sepsis-1. ![]() Overall, prediction and early detection of sepsis are still challenging in the absence of suitable biomarkers and a gold-standard diagnostic test. On the other hand, unnecessary antibiotic treatment due to a wrong sepsis diagnosis may contribute to antimicrobial resistance ( 5, 6). As each hour of delayed effective antibiotic treatment increases mortality, timely detection and treatment of sepsis are crucial and improve clinical outcome and survival ( 4). ![]() Sepsis ( 1) is the leading cause of death in intensive care units (ICUs) and has an immense medical, societal and economic relevance ( 2, 3). Our prospective SIRS algorithm provides dynamic determination of SIRS criteria and descriptors, allowing their integration in sepsis risk models also in other settings. Hence, the original expert-defined SIRS criteria are valid, capturing important sepsis risk determinants. For sepsis diagnosis, all SIRS criteria are relevant, with the temperature criterion being most influential.Ĭonclusion: SIRS is relevant for sepsis prediction and diagnosis in polytrauma, and no criterion should a priori be omitted. For sepsis prediction, temperature and tachypnea are the most important SIRS criteria, whereas the leukocytes criterion is least important and potentially even counterproductive. Risk models containing only the SIRS level average mostly show reasonable performance across criteria weights, with prediction and diagnosis AUROCs ranging from 0.455 (weight on leukocyte criterion only) to 0.693 and 0.619 to 0.800, respectively. Results: Our models perform better for the diagnosis than the prediction task (maximum AUROC 0.816 vs. We determine the importance of individual SIRS criteria by systematically varying criteria weights when summarizing the SIRS algorithm output with SIRS descriptors and assessing the classification performance of the resulting logistic regression models using a specifically developed ranking score. Two clinically relevant tasks are considered: (i) sepsis prediction using the first 24 h after admission to our ICU, and (ii) sepsis diagnosis using the last 24 h before sepsis onset and a time point of comparable ICU treatment duration for controls, respectively. Methods: We used a dynamic and prospective SIRS algorithm tailored to the ICU setting by accounting for catecholamine therapy and mechanical ventilation. Objective: We retrospectively elucidate the individual contributions of the SIRS criteria in a polytrauma cohort from the post-surgical ICU of University Medical Center Mannheim (Germany). While SIRS was controversially abandoned from the current sepsis definition, a dynamic SIRS representation still has potential for sepsis prediction and diagnosis. ![]() Systemic inflammatory response syndrome (SIRS) refers to the concurrent fulfillment of at least two out of the following four clinical criteria: tachycardia, tachypnea, abnormal body temperature, and abnormal leukocyte count.
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