Imperial College London
Alternate

DrGregoryQuinlan

Faculty of Medicine, National Heart & Lung Institute

Senior Research Fellow
 
 
 
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Contact

 

g.quinlan

 
 
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Location

 

B140BGuy Scadding BuildingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{MacCallum:2014:10.1378/chest.13-1023,
author = {MacCallum, NS and Finney, SJ and Gordon, SE and Quinlan, GJ and Evans, TW},
doi = {10.1378/chest.13-1023},
journal = {Chest},
pages = {1197--1203},
title = {Modified criteria for the systemic inflammatory response syndrome improves their utility following cardiac surgery},
url = {http://dx.doi.org/10.1378/chest.13-1023},
volume = {145},
year = {2014}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundDebate remains regarding whether the systemic inflammatory response syndrome (SIRS) identifies patients with clinically important inflammation. Defining criteria may be disproportionately sensitive and lack specificity. We investigated the incidence and evolution of SIRS in a homogenous population (following cardiac surgery) over 7 days to establish the relationship between SIRS and outcome, modeling alternative permutations of the criteria to increase their discriminatory power for mortality, length of stay, and organ dysfunction.MethodsWe conducted a retrospective analysis of prospectively collected data from a cardiothoracic ICU. Consecutive patients requiring ICU admission for the first time after cardiac surgery (N = 2, 764) admitted over a 41-month period were studied.ResultsConcurrently, 96.2% of patients met the standard two criterion definition for SIRS within 24 h of ICU admission. Their mortality was 2.78%. By contrast, three or four criteria were more discriminatory of patients with higher mortality (4.21% and 10.2%, respectively). A test dataset suggested that meeting two criteria for at least 6 consecutive h may be the best model. This had a positive and negative predictive value of 7% and 99.5%, respectively, in a validation dataset. It performed well at predicting organ dysfunction and prolonged ICU admission.ConclusionsThe concept of SIRS remains valid following cardiac surgery. With suitable modification, its specificity can be improved significantly. We propose that meeting two or more defining criteria for 6 h could be used to define better populations with more difficult clinical courses following cardiac surgery. This group may merit a different clinical approach.
AU  - MacCallum,NS
AU  - Finney,SJ
AU  - Gordon,SE
AU  - Quinlan,GJ
AU  - Evans,TW
DO  - 10.1378/chest.13-1023
EP  - 1203
PY  - 2014///
SN  - 0012-3692
SP  - 1197
TI  - Modified criteria for the systemic inflammatory response syndrome improves their utility following cardiac surgery
T2  - Chest
UR  - http://dx.doi.org/10.1378/chest.13-1023
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000337355600011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://journal.chestnet.org/article/S0012-3692(15)34790-5/fulltext
VL  - 145
ER  -
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