UMEM Educational Pearls

SIRS and Severe Sepsis Screening

  • Sepsis remains one of the most common critical illnesses managed by emergency medicine and critical care physicians.
  • Many EDs and ICUs have screening protocols for early detection of the patient with sepsis. Most protocols use the systemic inflammatory response syndrome (SIRS) as a central component of early identification.
  • A recent study stresses caution when simply using the SIRS criteria to screen for severe sepsis:
    • Retrospective review of the ANZICS Adult Database
    • Divided patients into SIRS-positive ( 2 SIRS criteria with at least 1 organ failure) and SIRS-negative ( < 2 SIRS criteria with at least 1 organ failure)
    • 109,663 patients
    • 12% of patients diagnosed with severe sepsis or at least 1 organ failure had < 2 SIRS criteria at admission.
    • Mortality for the SIRS-negative cohort remained relatively high at 16.1%
  • Take Home Point
    • Using the SIRS criteria to screen patients for severe sepsis will miss 1 out of every 8 patients with infection and organ dysfunction.


Kaukonen KM, Bailey M, Pilcher D, et al. Systemic Inflammatory Response Syndrome Criteria in Defining Severe Sepsis. NEJM 2015;372:1629-38.