Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
J Vet Emerg Crit Care (San Antonio). 2023 May-Jun;33(3):315-326. doi: 10.1111/vec.13293. Epub 2023 Apr 22.
Evaluate the clinical utility of the systemic inflammatory response syndrome (SIRS) criteria in dogs and cats presenting to an emergency room (ER).
Prospective and retrospective observational study, conducted from November 2019 to February 2020.
Small animal university teaching hospital.
Prospective enrollment of 1143 dogs and 384 cats consecutively presenting to the ER. Retrospective enrollment of 65 healthy dogs and 57 healthy cats consecutively presenting to the primary care (PC) service.
None.
Positive SIRS-3 status was defined as meeting ≥2 of 3 (dogs) or 3 of 3 (cats) of the vital parameter SIRS criteria (temperature, heart rate, and respiratory rate). Positive SIRS-4 status was defined as meeting ≥2 of 4 (dogs) and ≥3 of 4 (cats) of the vital parameter and CBC SIRS criteria. For each species, proportions of SIRS-positive animals were compared between the ER and PC groups. Clinical outcomes were compared between SIRS-positive and SIRS-negative patients presenting to ER. The number of SIRS-3-positive dogs was statistically but not clinically different between the ER (69.9%) and PC (53.8%) groups (P = 0.009). Overall survival rate was 83% for SIRS-3-positive and 89% for SIRS-3-negative dogs presented to ER (P = 0.007). The number of SIRS-3-positive cats did not differ between ER and PC groups (P > 0.999). Overall survival rate was 61.1% for SIRS-4-positive and 86.8% for SIRS-4-negative cats presented to ER (P = 0.012).
Fulfilling the SIRS criteria is common in dogs and rare in cats regardless of presenting service. Meeting SIRS criteria on ER presentation carries a weak negative survival association in dogs and a moderate negative survival association in cats. This study demonstrates that the SIRS criteria have poor discriminatory ability to differentiate healthy from diseased patients and lacks a strong outcome correlation in small animal patients.
评估全身炎症反应综合征（SIRS）标准在急诊就诊的犬猫中的临床实用性。
前瞻性和回顾性观察性研究，于 2019 年 11 月至 2020 年 2 月进行。
小型动物教学医院。
前瞻性纳入 1143 只犬和 384 只猫，连续就诊于急诊；回顾性纳入 65 只健康犬和 57 只健康猫，连续就诊于初级保健（PC）服务。
无。
阳性 SIRS-3 状态定义为满足体温、心率和呼吸频率 3 项生命体征 SIRS 标准中的≥2 项（犬）或 3 项（猫）；阳性 SIRS-4 状态定义为满足体温、心率、呼吸频率和全血细胞计数（CBC）4 项生命体征和 SIRS 标准中的≥2 项（犬）和≥3 项（猫）。比较两种动物在急诊和 PC 组中 SIRS 阳性动物的比例。比较急诊就诊的 SIRS 阳性和 SIRS 阴性患者的临床结局。在急诊就诊的犬中，SIRS-3 阳性的比例在统计学上但临床上与 PC 组（69.9%比 53.8%）不同（P=0.009）。就诊于急诊的 SIRS-3 阳性犬的总生存率为 83%，SIRS-3 阴性犬为 89%（P=0.007）。SIRS-3 阳性猫在急诊和 PC 组之间无差异（P＞0.999）。就诊于急诊的 SIRS-4 阳性猫的总生存率为 61.1%，SIRS-4 阴性猫为 86.8%（P=0.012）。
无论就诊服务如何，符合 SIRS 标准在犬中很常见，在猫中则很少见。在急诊就诊时满足 SIRS 标准与犬的生存负相关弱，与猫的生存负相关中度相关。本研究表明，SIRS 标准对区分健康和患病患者的能力较差，且与小动物患者的预后相关性不强。
