Systemic inflammatory response syndrome, infection, and outcome in intracerebral hemorrhage.

Published online

Journal Article

Objective: Systemic inflammatory response syndrome (SIRS) may be related to poor outcomes after intracerebral hemorrhage (ICH). Methods: The Ethnic/Racial Variations of Intracerebral Hemorrhage study is an observational study of ICH in whites, blacks, and Hispanics throughout the United Sates. SIRS was defined by standard criteria as 2 or more of the following on admission: (1) body temperature <36°C or >38°C, (2) heart rate >90 beats per minute, (3) respiratory rate >20 breaths per minute, or (4) white blood cell count <4,000/mm3 or >12,000/mm3. The relationship among SIRS, infection, and poor outcome (modified Rankin Scale [mRS] 3-6) at discharge and 3 months was assessed. Results: Of 2,441 patients included, 343 (14%) met SIRS criteria at admission. Patients with SIRS were younger (58.2 vs 62.7 years; p < 0.0001) and more likely to have intraventricular hemorrhage (IVH; 53.6% vs 36.7%; p < 0.0001), higher admission hematoma volume (25.4 vs 17.5 mL; p < 0.0001), and lower admission Glasgow Coma Scale (GCS; 10.7 vs 13.1; p < 0.0001). SIRS on admission was significantly related to infections during hospitalization (adjusted odds ratio [OR] 1.36, 95% confidence interval [CI] 1.04-1.78). In unadjusted analyses, SIRS was associated with poor outcomes at discharge (OR 1.96, 95% CI 1.42-2.70) and 3 months (OR 1.75, 95% CI 1.35-2.33) after ICH. In analyses adjusted for infection, age, IVH, hematoma location, admission GCS, and premorbid mRS, SIRS was no longer associated with poor outcomes. Conclusions: SIRS on admission is associated with ICH score on admission and infection, but it was not an independent predictor of poor functional outcomes after ICH.

Full Text

Duke Authors

Cited Authors

  • Boehme, AK; Comeau, ME; Langefeld, CD; Lord, A; Moomaw, CJ; Osborne, J; James, ML; Martini, S; Testai, FD; Woo, D; Elkind, MSV

Published Date

  • March 2018

Published In

Volume / Issue

  • 5 / 2

Start / End Page

  • e428 -

PubMed ID

  • 29318180

Pubmed Central ID

  • 29318180

International Standard Serial Number (ISSN)

  • 2332-7812

Digital Object Identifier (DOI)

  • 10.1212/NXI.0000000000000428

Language

  • eng

Conference Location

  • United States