Study Shows Most With Condition Do Not Develop Sepsis, Contrary to Definitions Set By Medical Groups

ST. LOUIS -- To identify hospital patients at risk for severe sepsis, the most common cause of death in hospital intensive-care units, the American College of Chest Physicians and the Society for Critical Care Medicine two years ago adopted new definitions of sepsis and conditions that precede it.

Now, a study by researchers at the University at Buffalo's Center for Pharmacoepidemiology concludes that one of the revised definitions may, in fact, raise false alarms.

The study found that contrary to the definitions, 72.3% of patients with systemic inflammatory response syndrome (SIRS), considered under the definitions to be a precursor of severe sepsis, do not go on to develop the condition, which is so complex that it's been described by one recent observer as "the Bermuda Triangle of the pharmaceutical industry."

Kathi Conboy, doctoral candidate in the UB Department of Social and Preventive Medicine and co-author of the study, presented the results here today (Tuesday, August 2) at the annual meeting of the American College of Clinical Pharmacy.

"Our study shows that while these definitions are a first step, we need to validate these clinical concepts and measures of inflammation in patient populations," said Conboy.

She explained that the new definitions were supposed to describe a continuum, with SIRS in the initial stage and severe sepsis, shock and multiple organ dysfunction occurring in the later stages.

"SIRS is definitely a red flag, but these definitions are still evolving," said Conboy. "Not every patient with SIRS is going to develop severe sepsis. It's a combination of signs, symptoms and other factors that will help identify those who are most at risk."

She said that when SIRS appears along with other risk factors, it may be an indication that that patient should be treated aggressively.

The UB study included 1,754 patients, one of the largest databases compiled on patients at risk of developing sepsis. A total of 1649 patients, or 94 percent of the group, developed SIRS.