Epidemiologic Study On Adult Patients With Systemic Inflammatory Response Syndrome In Emergency Depatrment

ObjectiveTo investigate the incidence of SIRS in adults admitted in emergency department, andits demographic characteristics, feature and outcome of infection, and risk factors.Screen effective warning indicators of SIRS which are beneficial for its early diagnosis,risk stratification, and thereby improve the condition of its treatment. The study can fillthe blank of epidemiology of SIRS in domestic emergency department. Meanwhile,these epidemiologic data can provide important reference for emergency triage andrational allocation of medical resources. Moreover, the research results can alsoprovide valid information for public health policy-making.MethodsA cross-sectional, prospective point prevalence study was conducted on all adults(n=5897) admitted in emergency department in16tertiary hospitals. Five time periods,of each is24-hour were collected from Nov1,2012to Feb1,2013. Each patient atadmission was recorded demographic data, vital signs, laboratory test results, pastmedical history, the initial diagnosis and prognosis. Diagnostic criteria of SIRS was inaccordance with that made by American College of Chest Physicians Association(ACCP) and Society of Critical Care Medicine (SCCM) in1992. Adult patients withSIRS can be included in this study. Data collection were blind, all questionnaires werecoded and recorded into Rui Da Electronic database (eRDDM V1.0). Epidata3.0wasused in SIRS database, and SPSS17.0software was used to analyze the prevalence ofSIRS, risk factors, characteristics of infection, and differences of the outcome of patients with and without SIRS.Results6284patients were admitted in emergency department all over the16hospitals.264patients who are less than18-year-old were excluded. Another123patients whose datawere recorded incompletely were also excluded our study. Finally,5897cases wereincluded in the study. According to the ACCP and SCCM,1180patients (age49.3±20.4years old) were diagnosed SIRS,4717patients (age47.4±19.3years) werenon-SIRS. The difference of age between the two groups was statistically significant(approximate T-test, P <0.05). The prevalence of SIRS is20.01%. Among patients withSIRS,644cases were male while other536cases were female. There is a significantdifference of incidence rate between male and female (Chi-Square test, P <0.05). Themost common cause for patients with SIRS is respiratory disease. Of all the SIRScriteria, tachycardia (89.2%) and respiratory rate (67.9%) were the most common, andfollowed by body temperature (53.6%) and white blood cell count (46.3%). Of all thepatients at admission, the number of patients with surgery diseases is880. The rate ofhospitalization between patients with SIRS and without SIRS is significantly different.Logistic regression analysis showed that patients with some underlying disease aresusceptible to SIRS, especially those with metastatic cancer, myocardial infarction.ConclusionThe prevalence of SIRS in emergency department is20.01%in China. Men are moresusceptible to SIRS than women. The incidence of sepsis is40.09%among patientswith SIRS. Medical staffs in emergency department should be alert to patients withmetastatic cancer, myocardial ischemia and hematological malignancies. For patientswho suffer from respiratory diseases, nurses should assess them appropriately andpromptly so that the clinician can identify SIRS early and then treat and intervene them effectively. The epidemiological studies of SIRS play an important role in rationalallocation of medical resources, and also can improve the prognosis of patients withSIRS, thereby reduce the incidence of sepsis.