Which systemic inflammatory response syndrome (SIRS) etiology increases the mortality risk?

Updated: Nov 12, 2020
  • Author: Kamran Boka, MD, MS; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Sinning et al evaluated the SIRS criteria in patients who underwent transcatheter aortic valve implantation (TAVI) and found that SIRS appeared to be a strong predictor of mortality. The occurrence of SIRS was characterized by a significantly elevated release of IL-6 and IL-8, with subsequent increase in the leukocyte count, C-reactive protein (CRP), and procalcitonin. The occurrence of SIRS was related to 30-day and 1-year mortality (18% vs 1.1% and 52.5% vs 9.9%, respectively) and independently predicted 1-year mortality risk. [18]

In the aforementioned Heffner et al study, patients without an identified infection had a lower hospital mortality rate than did patients with an infectious etiology for their SIRS (9% vs 15%, respectively). [13]

As mentioned in Background, the redefined definitions by the 2016 SCCM/EISCM task force support that (1) sepsis requires organ dysfunction and (2) the concepts of SIRS and severe sepsis are eliminated. Furthermore, the task force recommends SOFA as the tool to assess severity of organ dysfunction in a potentially septic patient; the authors had concluded that SOFA has superior predictive validity for in-hospital mortality as compared with SIRS. [2]


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