Background: Admission systemic inflammatory response syndrome (SIRS) score has been previously reported to be an accurate predictor of infection and outcome in trauma. However, these data were limited to only one SIRS score at admission. A prior study in surgical intensive care unit (ICU) patients reported that the SIRS score on ICU day 2 declined after completion of resuscitation, and was a more accurate predictor of outcome. Our objective in this follow-up study was to prospectively evaluate the utility of daily SIRS scores in prediction of nosocomial infection and outcome in high-risk trauma patients.
Methods: Prospective data were collected on 702 consecutive trauma patients admitted over a 12-month period to the ICU. SIRS scores were calculated daily. Centers for Disease Control and Prevention guidelines were used for the diagnosis of infection. Multivariate linear regression was used for statistical analysis.
Results: Five hundred seventy-three (82%) patients sustained blunt injuries and 129 (18%) sustained penetrating injuries. The mean age was 43 +/- 21 years, with an overall mortality of 11.4%. Two hundred ninety (41.3%) of the study patients acquired a nosocomial infection (respiratory site most common), with an associated mortality rate of 12.4%. SIRS (defined as SIRS score >/= 2) on hospital days 3 through 7 was a significant predictor of nosocomial infection and hospital length of stay. Persistent SIRS to hospital day 7 was associated with a significant risk for increased mortality (relative risk, 4.7; 95% confidence interval, 1.41-12.87; p = 0.047).
Conclusion: Persistent SIRS is predictive of nosocomial infection in trauma. Daily monitoring of SIRS scores is easily accomplished and should be considered in all high-risk trauma patients. Persistent SIRS in trauma should initiate early diagnostic interventions for determination of source of infection, and consideration of early empiric antimicrobial therapy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/00005373-200208000-00010 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Potential Zoonotic Infections Transmitted by Free-Ranging Macaques in Human-Monkey Conflict Areas in Thailand.
Zoonoses Public Health
January 2025
Monitoring and Surveillance Center for Zoonotic Diseases in Wildlife and Exotic Animals, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand.
Introduction: Nonhuman primates (NHPs) can transmit zoonotic diseases to humans because of their close genetic relationship, facilitating the cross-species transmission of certain pathogens. In Thailand, Macaca is the most common NHP genus and their inhabits area are in close proximity of human, particularly in urban and suburban areas, where frequent interactions with humans increase the risk of pathogen transmission. The risk is influenced by factors such as the type of pathogen, the mode of transmission (e.
View Article and Find Full Text PDFTrichomoniasis in Men: A Neglected Factor in Male Infertility?
Acta Parasitol
January 2025
Department of Medical Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, P.O. Box: 65157838736, Hamadan, Iran.
Purpose: This study is aimed to detect the frequency of trichomoniasis, a sexually transmitted infection caused by an anaerobic protozoan Trichomonas vaginalis, in men referred to the Fertility and Infertility Research Center Hamadan University of Medical Sciences.
Methods: In this cross-sectional study, a group of 197 male volunteers who sought medical attention for issues related to infertility participated. The urine and semen samples were collected in sterile conditions.
Genomic analyses reveal high diversity and rapid evolution of within a neonatal intensive care unit in Delhi, India.
Antimicrob Agents Chemother
January 2025
Medical Mycology Unit, Department of Microbiology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
causes life-threatening infections in immunocompromised hosts, including hospitalized neonates. This pathogen is intrinsically resistant to fluconazole, while uncommon strains resistant to multiple antifungal drugs, including voriconazole, amphotericin B, and echinocandins, have also been reported from healthcare environments. Thus, understanding how spread, persist, and adapt to healthcare settings could help us develop better infection management strategies.
View Article and Find Full Text PDFInsect-specific Alphamesonivirus-1 () in lymph node and lung tissues from two horses with acute respiratory syndrome.
J Virol
January 2025
Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise, Teramo, Italy.
Unlabelled: Members of the RNA virus order infect hosts ranging from marine invertebrates to terrestrial mammals. As such, understanding the determinants of host range in this group of viruses, as well as their patterns of emergence and disease potential, is of clear importance. The are a recently documented family within the .
View Article and Find Full Text PDFMicrogeographical Variation in Prevalence in Dogs in Suburban and Urban Areas of Rio De Janeiro, Brazil.
Vet Sci
December 2024
School of Biodiversity, One Health and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Garscube Estate, Glasgow G61 1QH, UK.
Dirofilariosis, a mosquito-borne disease caused by and , affects canids, felids and occasionally humans. Recent evidence suggests that prevalence is rising in the canine populations in several areas of Brazil, even those historically considered to be non-endemic, highlighting the need for ongoing surveillance. However, prevalence studies are frequently based on inference from single diagnostic methods, and it is acknowledged that this may lead to biases and an underestimation of the disease situation.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!