H-Index
79
Scimago Lab
powered by Scopus
JCR
Clarivate
Analytics
12%
Acceptance
Rate
call: +1.631.470.9640
Mon-Fri 10 am - 2 pm EST

Logo

Medical Science Monitor Basic Research
AmJCaseRep

Annals
ISI-Home

eISSN: 1643-3750

Get your full text copy in PDF

Systemic Inflammatory Response Syndrome (SIRS) and the Pattern and Risk of Sepsis Following Gastrointestinal Perforation

Zhou Ye-Ting, Tong Dao-Ming

(Department of General Surgery, Affiliated Shuyang Peoples’ Hospital, Xuzhou Medical University, Xuzhou, Jiangsu, China (mainland))

Med Sci Monit 2018; 24: CLR3888-3894

DOI: 10.12659/MSM.907922


BACKGROUND: Systemic inflammatory response syndrome (SIRS) is characterized by systemic inflammation and tissue injury. Secondary sepsis is a common critical illness associated with poor clinical outcome. The aim of this study was to investigate the risk of SIRS-positive and SIRS-negative sepsis following gastrointestinal (GI) perforation.
MATERIAL AND METHODS: A retrospective study included 51 patients with GI perforation who had clinical evidence of sepsis, with or without SIRS. Clinical outcome was assessed at day 30 using the Glasgow Outcome Scale (GOS) (score, 1–5) and the sequential organ failure assessment (SOFA) (score, 1–6) to determine organ function.
RESULTS: Fifty-one patients were included in the study (median age, 74 years; 37 male patients); 20 patients (39.2%) developed secondary sepsis; 16 patients (80%) had SIRS-negative sepsis; four patients had SIRS-positive sepsis. An increased SOFA score was a significant independent predictor of GI perforation with sepsis (5.4±3.1 vs. 1.5±2.8) (P<0.0001). Patients with GI perforation with SIRS-negative sepsis had a significantly less favorable outcome (5/16 vs. 2/35) (P=0.03). The risk of SIRS-negative sepsis following GI perforation was 39.2%, and the risk of mortality for SIRS-negative sepsis was 31.3%. In the Cox regression analysis, septic shock and septic encephalopathy were associated with a worse clinical outcome.
CONCLUSIONS: The findings of this study support the recognition of SIRS-negative sepsis following GI perforation as an important condition to recognize clinically, given its association with increased patient morbidity and mortality.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree