<i>Annals</i> for Hospitalists Inpatient Notes - Sepsis-3 for Hospitalists—Sepsis Without SIRS
Authors: Sushant Govindan, Theodore J. Iwashyna
Journal: Annals of Internal Medicine (2016)

Web Exclusives16 August 2016Annals for Hospitalists Inpatient Notes - Sepsis-3 for Hospitalists—Sepsis Without SIRSSushant Govindan, MD and Theodore J. Iwashyna, MD, PhDSushant Govindan, MDFrom the University of Michigan Health System and the Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.Search for more papers by this author and Theodore J. Iwashyna, MD, PhDFrom the University of Michigan Health System and the Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1507 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Spurred by inconsistent clinical recognition of sepsis, significant mortality, and lack of reliability of the current definition, the Sepsis-3 Task Force recently published a new approach to sepsis (1).Sepsis was once believed to be the direct toxic effect of pathogens. The Sepsis-1 (1992) and -2 (2001) Task Forces argued, instead, that infection often kills through the body's inflammatory response. Coupled to this reframing was the hope that systemic inflammatory response syndrome (SIRS) criteria would identify patients with such a response. For 20 years, we have taught that the diagnosis of sepsis is based on having 2 or more SIRS ...References1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:801-10. [PMID: 26903338] doi:10.1001/jama.2016.0287 CrossrefMedlineGoogle Scholar2. Kaukonen KM, Bailey M, Pilcher D, Cooper DJ, Bellomo R. Systemic inflammatory response syndrome criteria in defining severe sepsis. N Engl J Med. 2015;372:1629-38. [PMID: 25776936] doi:10.1056/NEJMoa1415236 CrossrefMedlineGoogle Scholar3. Churpek MM, Zadravecz FJ, Winslow C, Howell MD, Edelson DP. Incidence and prognostic value of the systemic inflammatory response syndrome and organ dysfunctions in ward patients. Am J Respir Crit Care Med. 2015;192:958-64. [PMID: 26158402] doi:10.1164/rccm.201502-0275OC CrossrefMedlineGoogle Scholar4. Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:762-74. [PMID: 26903335] doi:10.1001/jama.2016.0288 CrossrefMedlineGoogle Scholar5. Simpson SQ. New sepsis criteria: a change we should not make [Editorial]. Chest. 2016;149:1117-8. [PMID: 26927525] doi:10.1016/j.chest.2016.02.653 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the University of Michigan Health System and the Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.Disclaimer: This work does not represent the views of the U.S. government or the Department of Veterans Affairs.Financial Support: Grant IIR 13-079 from the Veterans Affairs Health Services Research & Development Service.Disclosures: Dr. Iwashyna reports grants from Veterans Affairs Health Services Research & Development Service during the conduct of the study. Dr. Govindan has disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1507.Requests for Single Reprints: Sushant Govindan, MD, University of Michigan Health System, 1500 East Medical Center Drive, SPC 5376, Ann Arbor, MI 48109; e-mail, [email protected]umich.edu.Current Author Addresses: Dr. Govinden: University of Michigan Health System, 1500 East Medical Center Drive, SPC 5376, Ann Arbor, MI 48109.Dr. Iwashyna: Veterans Affairs Ann Arbor Healthcare System, 300 North Ingalls Building, Ann Arbor, MI 48109. Previousarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - 16 August 2016 David H. Wesorick and Vineet Chopra Metrics Cited byAlcohol-based hand rub and incidence of healthcare associated infections in a rural regional referral and teaching hospital in Uganda (‘WardGel’ study) 16 August 2016Volume 165, Issue 4Page: HO2-HO3KeywordsDisclosureHealth services researchHospitalistsIntensive care unitsMortalityQuick sequential organ failure assessmentSepsisSequential organ failure assessmentSystemic inflammatory response syndromeVeteran care ePublished: 16 August 2016 Issue Published: 16 August 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...