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Published in: Neurocritical Care 1/2016

01-08-2016 | Original Article

Systemic Inflammatory Response Syndrome and Outcomes in Intracerebral Hemorrhage

Authors: Amelia K. Boehme, Angela N. Hays, Kimberly P. Kicielinski, Kanika Arora, Niren Kapoor, Michael J. Lyerly, Alissa Gadpaille, Harn Shiue, Karen Albright, David Miller, Mitchell S. V. Elkind, Mark R. Harrigan

Published in: Neurocritical Care | Issue 1/2016

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Abstract

Background

To identify the patients at greatest odds for systemic inflammatory response syndrome (SIRS) and examine the association between SIRS and outcomes in patients presenting with intracerebral hemorrhage (ICH).

Methods

We retrospectively reviewed consecutive patients presenting to a tertiary care center from 2008 to 2013 with ICH. SIRS was defined according to standard criteria as 2 or more of the following: (1) body temperature <36 or >38 °C, (2) heart rate >90 beats per minute, (3) respiratory rate >20, or (4) white blood cell count <4000/mm3 or >12,000/mm3 or >10 % polymorphonuclear leukocytes for >24 h in the absence of infection. The outcomes of interest, discharge modified Rankin Scale (mRS 4–6), death, and poor discharge disposition (discharge anywhere but home or inpatient rehab) were assessed using logistic regression.

Results

A total of 249 ICH patients met inclusion criteria and 53 (21.3 %) developed SIRS during their hospital stay. A score was developed (ranging from 0 to 3) to identify patients at greatest risk for developing SIRS. Adjusting for stroke severity, SIRS was associated with mRS 4–6 (OR 5.25, 95 %CI 2.09–13.2) and poor discharge disposition (OR 3.74, 95 %CI 1.58–4.83) but was not significantly associated with death (OR 1.75, 95 %CI 0.58–5.32). We found that 33 % of the effect of ICH score on poor functional outcome at discharge was explained by the development of SIRS in the hospital (Sobel 2.11, p = 0.03).

Conclusion

We observed that approximately 20 % of patients with ICH develop SIRS, and that patients with SIRS were at increased risk of having poor functional outcome at discharge.
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Metadata
Title
Systemic Inflammatory Response Syndrome and Outcomes in Intracerebral Hemorrhage
Authors
Amelia K. Boehme
Angela N. Hays
Kimberly P. Kicielinski
Kanika Arora
Niren Kapoor
Michael J. Lyerly
Alissa Gadpaille
Harn Shiue
Karen Albright
David Miller
Mitchell S. V. Elkind
Mark R. Harrigan
Publication date
01-08-2016
Publisher
Springer US
Published in
Neurocritical Care / Issue 1/2016
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-016-0255-9

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