Utility of the systemic inflammatory response syndrome (SIRS) criteria in predicting the onset of septic shock in hospitalized patients with hematologic malignancies

Anthony R. Mato, Barry D. Fuchs, Daniel F. Heitjan, Rosemarie Mick, Scott D. Halpern, Payal D. Shah, Samantha Jacobs, Erin Olson, Stephen J. Schuster, Chaitra Ujjani, Elise A. Chong, Alison W. Loren, Andrea N. Miltiades, Selina M. Luger

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM). Objective: To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS). Main results: In total 8.4% of subjects developed SS. SIRS scores measured 24 h prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4, p < 0.0001). Using standard SIRS cutpoints, fever, tachypnea and tachycardia were each associated with the onset of SS. Population-specific SIRS criteria were empirically derived. Design: Observational, single-center, nested case-control study. Setting: Oncology unit of a tertiary care center. Patients: Five hundred and forty-seven consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases. Measurements: The study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization. Limitations: Single-center study. Further validation is warranted. Conclusions: SIRS can identify HM patients at risk for SS at least 24 h before SS onset. These data may lead to evidence-based guidelines using routine vital signs to risk-stratify HM patients for SS.

Original languageEnglish (US)
Pages (from-to)1095-1100
Number of pages6
JournalCancer Biology and Therapy
Volume8
Issue number12
DOIs
StatePublished - Jun 15 2009

Fingerprint

Systemic Inflammatory Response Syndrome
Hematologic Neoplasms
Septic Shock
Tachypnea
Vital Signs
Tertiary Care Centers
Tachycardia
Case-Control Studies
Hospitalization
Fever
Outcome Assessment (Health Care)
Guidelines

Keywords

  • Bacteremia
  • Febrile neutropenia
  • Hematologic malignancies
  • Infection
  • Leukemia
  • Lymphoma
  • Neutropenic fever
  • Sepsis
  • Septic shock
  • SIRS criteria

ASJC Scopus subject areas

  • Molecular Medicine
  • Oncology
  • Pharmacology
  • Cancer Research

Cite this

Utility of the systemic inflammatory response syndrome (SIRS) criteria in predicting the onset of septic shock in hospitalized patients with hematologic malignancies. / Mato, Anthony R.; Fuchs, Barry D.; Heitjan, Daniel F.; Mick, Rosemarie; Halpern, Scott D.; Shah, Payal D.; Jacobs, Samantha; Olson, Erin; Schuster, Stephen J.; Ujjani, Chaitra; Chong, Elise A.; Loren, Alison W.; Miltiades, Andrea N.; Luger, Selina M.

In: Cancer Biology and Therapy, Vol. 8, No. 12, 15.06.2009, p. 1095-1100.

Research output: Contribution to journalArticle

Mato, AR, Fuchs, BD, Heitjan, DF, Mick, R, Halpern, SD, Shah, PD, Jacobs, S, Olson, E, Schuster, SJ, Ujjani, C, Chong, EA, Loren, AW, Miltiades, AN & Luger, SM 2009, 'Utility of the systemic inflammatory response syndrome (SIRS) criteria in predicting the onset of septic shock in hospitalized patients with hematologic malignancies', Cancer Biology and Therapy, vol. 8, no. 12, pp. 1095-1100. https://doi.org/10.4161/cbt.8.12.8528
Mato, Anthony R. ; Fuchs, Barry D. ; Heitjan, Daniel F. ; Mick, Rosemarie ; Halpern, Scott D. ; Shah, Payal D. ; Jacobs, Samantha ; Olson, Erin ; Schuster, Stephen J. ; Ujjani, Chaitra ; Chong, Elise A. ; Loren, Alison W. ; Miltiades, Andrea N. ; Luger, Selina M. / Utility of the systemic inflammatory response syndrome (SIRS) criteria in predicting the onset of septic shock in hospitalized patients with hematologic malignancies. In: Cancer Biology and Therapy. 2009 ; Vol. 8, No. 12. pp. 1095-1100.
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abstract = "Background: The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM). Objective: To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS). Main results: In total 8.4{\%} of subjects developed SS. SIRS scores measured 24 h prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4, p < 0.0001). Using standard SIRS cutpoints, fever, tachypnea and tachycardia were each associated with the onset of SS. Population-specific SIRS criteria were empirically derived. Design: Observational, single-center, nested case-control study. Setting: Oncology unit of a tertiary care center. Patients: Five hundred and forty-seven consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases. Measurements: The study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization. Limitations: Single-center study. Further validation is warranted. Conclusions: SIRS can identify HM patients at risk for SS at least 24 h before SS onset. These data may lead to evidence-based guidelines using routine vital signs to risk-stratify HM patients for SS.",
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AU - Mato, Anthony R.

AU - Fuchs, Barry D.

AU - Heitjan, Daniel F.

AU - Mick, Rosemarie

AU - Halpern, Scott D.

AU - Shah, Payal D.

AU - Jacobs, Samantha

AU - Olson, Erin

AU - Schuster, Stephen J.

AU - Ujjani, Chaitra

AU - Chong, Elise A.

AU - Loren, Alison W.

AU - Miltiades, Andrea N.

AU - Luger, Selina M.

PY - 2009/6/15

Y1 - 2009/6/15

N2 - Background: The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM). Objective: To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS). Main results: In total 8.4% of subjects developed SS. SIRS scores measured 24 h prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4, p < 0.0001). Using standard SIRS cutpoints, fever, tachypnea and tachycardia were each associated with the onset of SS. Population-specific SIRS criteria were empirically derived. Design: Observational, single-center, nested case-control study. Setting: Oncology unit of a tertiary care center. Patients: Five hundred and forty-seven consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases. Measurements: The study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization. Limitations: Single-center study. Further validation is warranted. Conclusions: SIRS can identify HM patients at risk for SS at least 24 h before SS onset. These data may lead to evidence-based guidelines using routine vital signs to risk-stratify HM patients for SS.

AB - Background: The systemic inflammatory response syndrome (SIRS) criteria have not been validated in patients with hematologic malignancies (HM). Objective: To determine whether daily assessment of SIRS criteria allows early identification of HM patients who will develop septic shock (SS). Main results: In total 8.4% of subjects developed SS. SIRS scores measured 24 h prior to SS were significantly higher in cases than in controls (2.1 vs. 1.4, p < 0.0001). Using standard SIRS cutpoints, fever, tachypnea and tachycardia were each associated with the onset of SS. Population-specific SIRS criteria were empirically derived. Design: Observational, single-center, nested case-control study. Setting: Oncology unit of a tertiary care center. Patients: Five hundred and forty-seven consecutive, hospitalized, HM subject were enrolled. Using incidence-density sampling, 184 controls were matched to 46 SS cases. Measurements: The study exposure was the SIRS score. The study outcome was the development of SS during the hospitalization. Limitations: Single-center study. Further validation is warranted. Conclusions: SIRS can identify HM patients at risk for SS at least 24 h before SS onset. These data may lead to evidence-based guidelines using routine vital signs to risk-stratify HM patients for SS.

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