Hernández G, Dougnac A, Castro J, Labarca E, Ojeda M, Bugedo G, Castillo L, Andresen M, Bruhn A, Huidobro L F, Huidobro R, Caballero M T, Hernández A
Programa de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Rev Med Chil. 1999 Nov;127(11):1339-44.
In 1992, a consensus conference defined the terms systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis and septic shock. Since then, numerous reports have validated the prognostic usefulness of these operative definitions.
To evaluate if sepsis severity criteria, as defined by the Consensus Conference, can be applied to noninfectious SIRS.
Five hundred eighteen patients admitted to 5 intensive care units (ICU) from 4 hospitals were prospectively evaluated during a 3 months period. Patients that met at least one severity criteria were included. SIRS etiology, organ dysfunction and evolution were recorded in each patient.
One hundred two patients were included: 79 with sepsis (group I) and 23 with noninfectious SIRS (group II). ICU and hospital mortality were comparable (43 and 48% in sepsis compared to 43 and 51% in non infectious SIRS). The most common sources of sepsis were pneumonia and peritonitis. Group II patients had a wide variety of diseases. ICU stay, APACHE score and number of organs with dysfunction were not different among groups. Only the incidence of renal dysfunction was higher in the septic group.
The Consensus sepsis severity criteria can be applied to noninfectious SIRS, defining a population subset with similar high mortality and organ dysfunction incidence, although with greatly heterogeneous etiologies.
1992年，一次共识会议定义了全身炎症反应综合征（SIRS）、脓毒症、严重脓毒症和脓毒性休克的术语。自那时以来，大量报告证实了这些操作性定义在预后方面的实用性。
评估共识会议定义的脓毒症严重程度标准是否可应用于非感染性SIRS。
在3个月期间，对来自4家医院的5个重症监护病房（ICU）收治的518例患者进行前瞻性评估。纳入至少符合一项严重程度标准的患者。记录每位患者的SIRS病因、器官功能障碍及病情演变情况。
纳入102例患者：79例脓毒症患者（I组）和23例非感染性SIRS患者（II组）。ICU死亡率和医院死亡率相当（脓毒症组分别为43%和48%，非感染性SIRS组分别为43%和51%）。脓毒症最常见的来源是肺炎和腹膜炎。II组患者患有多种疾病。各组间ICU住院时间、急性生理与慢性健康状况评分系统（APACHE）评分及功能障碍器官数量无差异。仅脓毒症组肾功能障碍的发生率较高。
共识脓毒症严重程度标准可应用于非感染性SIRS，确定了一个具有相似高死亡率和器官功能障碍发生率的人群亚组，尽管病因差异很大。
