Systemic Inflammatory Response Syndrome in Tissue-Type Plasminogen Activator-Treated Patients is Associated With Worse Short-term Functional Outcome

From the Stroke Center, Department of Neurology....., Department of Epidemiology, Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education, Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities and Minority Health & Health Disparities Research Center, Department of Biostatistics, School of Nursing, and Department of Anesthesiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
Stroke (Impact Factor: 5.72). 05/2013; 44(8). DOI: 10.1161/STROKEAHA.113.001371
Source: PubMed


Background and purpose:
Systemic inflammatory response syndrome (SIRS) is a generalized inflammatory state. The primary goal of the study was to determine whether differences exist in outcomes in SIRS and non-SIRS intravenous tissue-type plasminogen activator-treated patients.

Consecutive patients were retrospectively reviewed for the evidence of SIRS during their admission. SIRS was defined as the presence of ≥2 of the following: body temperature<36°C or >38°C, heart rate>90, respiratory rate>20, and white blood cells<4000/mm or >12 000 mm, or >10% bands. Patients diagnosed with infection (via positive culture) were excluded.

Of the 241 patients, 44 had evidence of SIRS (18%). Adjusting for pre-tissue-type plasminogen activator National Institutes of Health Stroke Scale, age, and race, SIRS remained a predictor of poor functional outcome at discharge (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.16-5.73; P=0.0197).

In our sample of tissue-type plasminogen activator-treated (tPA) patients, ~1 in 5 patients developed SIRS. Furthermore, we found the presence of SIRS to be associated with poor short-term functional outcomes and prolonged length of stay.

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Available from: Amelia Boehme
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