Systemic inflammatory response syndrome score at admission independently predicts mortality and length of stay in trauma patients

L. M. Napolitano, T. Ferrer, Jr McCarter, T. M. Scalea, P. S. Barie, M. Rhodes, D. B. Reath, J. Stanley Smith, M. A. Healey, J. T. Schultz, R. F. Sing, F. B. Knotts, T. Ferrer

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Abstract

Background: Recent studies have documented that the systemic inflammatory response syndrome (SIRS) score is a useful predictor of outcome in critical surgical illness. The duration and severity of SIRS are associated with posttrauma multiple organ dysfunction and mortality. We sought to determine whether the severity of SIRS at admission is an accurate predictor of mortality and length of stay (LOS) in trauma patients. Methods: Prospective data of 4,887 trauma admissions to a Level I trauma center over a 18-Month period (January 1997 to July 1998) were analyzed. Patients were stratified by age and Injury Severity Score (ISS), and a SIRS severity score (1 to 4) was calculated at admissions(1 point for each component present: fever or hypothermia, tachypnea, tachycardia, and leukocytosis). The SIRS score was evaluated as an independent predictor of mortality and LOS by χ2 and multivariate logistic regression. Results: Trauma patients (n 4,887, 83% blunt injuries, 72% male) had the following characteristics: 73.1% were age 18 to 45 years, 17.5% were age 46 to 65 years, and 9.4% were age ≥66 years; 77.7% had ISS less than 15, 18.8% had ISS 16 to 29, and 3.5% had ISS greater than 29. Analysis of valance adjusting for age and ISS determined that SIRS score of 2 was a significant predictor of LOS. Furthermore, the relative risk of death increased significantly with SIRS score of 2 when age and ISS were held constant. Conclusion: Logistic regression analysis confirmed that SIRS score of 2 was a significant independent predictor of increased mortality and LOS in trauma patients. These data suggest that admission SIRS scoring in trauma patients is a simple tool that may be used as a predictor of outcome and resource utilization.

Original languageEnglish (US)
Pages (from-to)647-653
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume49
Issue number4
DOIs
StatePublished - Jan 1 2000

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Systemic Inflammatory Response Syndrome
Length of Stay
Injury Severity Score
Mortality
Wounds and Injuries
Logistic Models
Tachypnea
Nonpenetrating Wounds
Trauma Centers
Leukocytosis
Hypothermia
Critical Illness
Tachycardia
Fever
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Napolitano, L. M. ; Ferrer, T. ; McCarter, Jr ; Scalea, T. M. ; Barie, P. S. ; Rhodes, M. ; Reath, D. B. ; Smith, J. Stanley ; Healey, M. A. ; Schultz, J. T. ; Sing, R. F. ; Knotts, F. B. ; Ferrer, T. / Systemic inflammatory response syndrome score at admission independently predicts mortality and length of stay in trauma patients. In: Journal of Trauma - Injury, Infection and Critical Care. 2000 ; Vol. 49, No. 4. pp. 647-653.
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abstract = "Background: Recent studies have documented that the systemic inflammatory response syndrome (SIRS) score is a useful predictor of outcome in critical surgical illness. The duration and severity of SIRS are associated with posttrauma multiple organ dysfunction and mortality. We sought to determine whether the severity of SIRS at admission is an accurate predictor of mortality and length of stay (LOS) in trauma patients. Methods: Prospective data of 4,887 trauma admissions to a Level I trauma center over a 18-Month period (January 1997 to July 1998) were analyzed. Patients were stratified by age and Injury Severity Score (ISS), and a SIRS severity score (1 to 4) was calculated at admissions(1 point for each component present: fever or hypothermia, tachypnea, tachycardia, and leukocytosis). The SIRS score was evaluated as an independent predictor of mortality and LOS by χ2 and multivariate logistic regression. Results: Trauma patients (n 4,887, 83{\%} blunt injuries, 72{\%} male) had the following characteristics: 73.1{\%} were age 18 to 45 years, 17.5{\%} were age 46 to 65 years, and 9.4{\%} were age ≥66 years; 77.7{\%} had ISS less than 15, 18.8{\%} had ISS 16 to 29, and 3.5{\%} had ISS greater than 29. Analysis of valance adjusting for age and ISS determined that SIRS score of 2 was a significant predictor of LOS. Furthermore, the relative risk of death increased significantly with SIRS score of 2 when age and ISS were held constant. Conclusion: Logistic regression analysis confirmed that SIRS score of 2 was a significant independent predictor of increased mortality and LOS in trauma patients. These data suggest that admission SIRS scoring in trauma patients is a simple tool that may be used as a predictor of outcome and resource utilization.",
author = "Napolitano, {L. M.} and T. Ferrer and Jr McCarter and Scalea, {T. M.} and Barie, {P. S.} and M. Rhodes and Reath, {D. B.} and Smith, {J. Stanley} and Healey, {M. A.} and Schultz, {J. T.} and Sing, {R. F.} and Knotts, {F. B.} and T. Ferrer",
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Napolitano, LM, Ferrer, T, McCarter, J, Scalea, TM, Barie, PS, Rhodes, M, Reath, DB, Smith, JS, Healey, MA, Schultz, JT, Sing, RF, Knotts, FB & Ferrer, T 2000, 'Systemic inflammatory response syndrome score at admission independently predicts mortality and length of stay in trauma patients', Journal of Trauma - Injury, Infection and Critical Care, vol. 49, no. 4, pp. 647-653. https://doi.org/10.1097/00005373-200010000-00011

Systemic inflammatory response syndrome score at admission independently predicts mortality and length of stay in trauma patients. / Napolitano, L. M.; Ferrer, T.; McCarter, Jr; Scalea, T. M.; Barie, P. S.; Rhodes, M.; Reath, D. B.; Smith, J. Stanley; Healey, M. A.; Schultz, J. T.; Sing, R. F.; Knotts, F. B.; Ferrer, T.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 49, No. 4, 01.01.2000, p. 647-653.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Systemic inflammatory response syndrome score at admission independently predicts mortality and length of stay in trauma patients

AU - Napolitano, L. M.

AU - Ferrer, T.

AU - McCarter, Jr

AU - Scalea, T. M.

AU - Barie, P. S.

AU - Rhodes, M.

AU - Reath, D. B.

AU - Smith, J. Stanley

AU - Healey, M. A.

AU - Schultz, J. T.

AU - Sing, R. F.

AU - Knotts, F. B.

AU - Ferrer, T.

PY - 2000/1/1

Y1 - 2000/1/1

N2 - Background: Recent studies have documented that the systemic inflammatory response syndrome (SIRS) score is a useful predictor of outcome in critical surgical illness. The duration and severity of SIRS are associated with posttrauma multiple organ dysfunction and mortality. We sought to determine whether the severity of SIRS at admission is an accurate predictor of mortality and length of stay (LOS) in trauma patients. Methods: Prospective data of 4,887 trauma admissions to a Level I trauma center over a 18-Month period (January 1997 to July 1998) were analyzed. Patients were stratified by age and Injury Severity Score (ISS), and a SIRS severity score (1 to 4) was calculated at admissions(1 point for each component present: fever or hypothermia, tachypnea, tachycardia, and leukocytosis). The SIRS score was evaluated as an independent predictor of mortality and LOS by χ2 and multivariate logistic regression. Results: Trauma patients (n 4,887, 83% blunt injuries, 72% male) had the following characteristics: 73.1% were age 18 to 45 years, 17.5% were age 46 to 65 years, and 9.4% were age ≥66 years; 77.7% had ISS less than 15, 18.8% had ISS 16 to 29, and 3.5% had ISS greater than 29. Analysis of valance adjusting for age and ISS determined that SIRS score of 2 was a significant predictor of LOS. Furthermore, the relative risk of death increased significantly with SIRS score of 2 when age and ISS were held constant. Conclusion: Logistic regression analysis confirmed that SIRS score of 2 was a significant independent predictor of increased mortality and LOS in trauma patients. These data suggest that admission SIRS scoring in trauma patients is a simple tool that may be used as a predictor of outcome and resource utilization.

AB - Background: Recent studies have documented that the systemic inflammatory response syndrome (SIRS) score is a useful predictor of outcome in critical surgical illness. The duration and severity of SIRS are associated with posttrauma multiple organ dysfunction and mortality. We sought to determine whether the severity of SIRS at admission is an accurate predictor of mortality and length of stay (LOS) in trauma patients. Methods: Prospective data of 4,887 trauma admissions to a Level I trauma center over a 18-Month period (January 1997 to July 1998) were analyzed. Patients were stratified by age and Injury Severity Score (ISS), and a SIRS severity score (1 to 4) was calculated at admissions(1 point for each component present: fever or hypothermia, tachypnea, tachycardia, and leukocytosis). The SIRS score was evaluated as an independent predictor of mortality and LOS by χ2 and multivariate logistic regression. Results: Trauma patients (n 4,887, 83% blunt injuries, 72% male) had the following characteristics: 73.1% were age 18 to 45 years, 17.5% were age 46 to 65 years, and 9.4% were age ≥66 years; 77.7% had ISS less than 15, 18.8% had ISS 16 to 29, and 3.5% had ISS greater than 29. Analysis of valance adjusting for age and ISS determined that SIRS score of 2 was a significant predictor of LOS. Furthermore, the relative risk of death increased significantly with SIRS score of 2 when age and ISS were held constant. Conclusion: Logistic regression analysis confirmed that SIRS score of 2 was a significant independent predictor of increased mortality and LOS in trauma patients. These data suggest that admission SIRS scoring in trauma patients is a simple tool that may be used as a predictor of outcome and resource utilization.

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U2 - 10.1097/00005373-200010000-00011

DO - 10.1097/00005373-200010000-00011

M3 - Article

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JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

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