Sirs in icu, a clinical study

Abstract

Localized inflammation is physiological protective response which is generally tightly controlled by the body at the site of injury. Loss of this local control or an overly activated response results in an exaggerated systemic response which is clinically identified as systemic inflammatory response syndrome (SIRS). Compensatory mechanism are initiated in concert with SIRS and outcome (resolution multiple organ dysfunction syndrome or death) is dependent on the balance of SIRS and such compensatory mechanisms. SIRS may occur in association with common non-infectious conditions such as high risk surgery and trauma. In fact mortality rates are similar between infectious and non-infectious conditions associated with SIRS. The incidence and associated mortality and morbidity rates of SIRS are commonly underestimated. This is a function of number of factors. Thus this study was done by evaluating clinical features and prognostic factors affecting course of SIRS, which would be useful in predicting the prognosis and deciding the treatment policies. METHODS: The present study has been carried out in the Department of General Medicine, Wanless Hospital, Miraj, in Sangli district of Maharashtra over a period from January 2019 to September 2020. A total 60 patients with SIRS were studied fulfilling the inclusion and exclusion criteria. It was a prospective observational clinical study. Consecutive type of non probability sampling was followed for the selection of study subjects. RESULTS: The prevalence of systemic inflammatory response syndrome was 24.48%.The majority of patients were in age group 41-50 years (30%). The mean age of patients was 42.11 ± 8.67 years. Out of 60 patients, majority of patients were females (53.33%) while males were 46.67%.The majority of patients were having symptom of fever (100%) followed by headache (70%), vomiting (53.33%), myalgia (46.67%), bleeding tendency (35%), abdominal pain (31.67%) and others (18.33%)The majority of patients were having Diabetes Mellitus & hypertension (18.33%). Among 60 patients, CVD, Stroke, thyroid disorders and kidney disorders was observed in 15%, 11.67%, 8.33% and 6.67% respectively. Among 60 patients, Multi organ failure, encephalopathy and ARDS was observed in 5%, 3.33% and 5% respectively. The mean hemoglobin was 12.73 ± 2.231 g/dl. The mean total bilirubin was 1.11 ± 0.40 mg/dl. The mean ALT was 24.86 ± 6.17. The mean AST was 23.53 ± 5.70. The mean blood urea was 31.96 ± 12.21 mg/dl. The mean serum creatinine was 2.76 ± 1.01.The mean APACHE II score was 21.9 ± 6.82. The mean MODS score was 6.63 ± 3.05.The mortality among patients with SIRS was 6.67%. CONCLUSION: SIRS is commonly present in patients presenting to the emergency department. Once SIRS is identified, it is crucially important to keep the patient under observation so that rapid and appropriate treatment can be initiated to decrease the mortality among patients.