Vital signs of the systemic inflammatory response syndrome in adult patients with acute infections presenting in out-of-hours primary care: A cross-sectional study.

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL European Journal of General Practice Pub Date : 2021-12-01 DOI:10.1080/13814788.2021.1917544
Feike J Loots, Daan Smulders, Paul Giesen, Rogier M Hopstaken, Marleen Smits
{"title":"Vital signs of the systemic inflammatory response syndrome in adult patients with acute infections presenting in out-of-hours primary care: A cross-sectional study.","authors":"Feike J Loots,&nbsp;Daan Smulders,&nbsp;Paul Giesen,&nbsp;Rogier M Hopstaken,&nbsp;Marleen Smits","doi":"10.1080/13814788.2021.1917544","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Signs of the systemic inflammatory response syndrome (SIRS) - fever (or hypothermia), tachycardia and tachypnoea - are used in the hospital setting to identify patients with possible sepsis.</p><p><strong>Objectives: </strong>To determine how frequently abnormalities in the vital signs of SIRS are present in adult out-of-hours (OOH) primary care patients with suspected infections and assess the association with acute hospital referral.</p><p><strong>Methods: </strong>We conducted a cross-sectional study at the OOH GP cooperative in Nijmegen, the Netherlands, between August and October 2015. GPs were instructed to record the body temperature, heart rate and respiratory rate of all patients with suspected acute infections. Vital signs of SIRS, other relevant signs and symptoms, and referral state were extracted from the electronic registration system of the OOH GP cooperative retrospectively. Logistic regression analysis was used to evaluate the association between clinical signs and hospital referral.</p><p><strong>Results: </strong>A total of 558 patients with suspected infections were included. At least two SIRS vital signs were abnormal in 35/409 (8.6%) of the clinic consultations and 60/149 (40.3%) of the home visits. Referral rate increased from 13% when no SIRS vital sign was abnormal to 68% when all three SIRS vital signs were abnormal. Independent associations for referral were found for decreased oxygen saturation, hypotension and rapid illness progression, but not for individual SIRS vital signs.</p><p><strong>Conclusion: </strong>Although patients with abnormal vital signs of SIRS were referred more often, decreased oxygen saturation, hypotension and rapid illness progression seem to be most important for GPs to guide further management.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"27 1","pages":"83-89"},"PeriodicalIF":2.3000,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13814788.2021.1917544","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of General Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13814788.2021.1917544","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Signs of the systemic inflammatory response syndrome (SIRS) - fever (or hypothermia), tachycardia and tachypnoea - are used in the hospital setting to identify patients with possible sepsis.

Objectives: To determine how frequently abnormalities in the vital signs of SIRS are present in adult out-of-hours (OOH) primary care patients with suspected infections and assess the association with acute hospital referral.

Methods: We conducted a cross-sectional study at the OOH GP cooperative in Nijmegen, the Netherlands, between August and October 2015. GPs were instructed to record the body temperature, heart rate and respiratory rate of all patients with suspected acute infections. Vital signs of SIRS, other relevant signs and symptoms, and referral state were extracted from the electronic registration system of the OOH GP cooperative retrospectively. Logistic regression analysis was used to evaluate the association between clinical signs and hospital referral.

Results: A total of 558 patients with suspected infections were included. At least two SIRS vital signs were abnormal in 35/409 (8.6%) of the clinic consultations and 60/149 (40.3%) of the home visits. Referral rate increased from 13% when no SIRS vital sign was abnormal to 68% when all three SIRS vital signs were abnormal. Independent associations for referral were found for decreased oxygen saturation, hypotension and rapid illness progression, but not for individual SIRS vital signs.

Conclusion: Although patients with abnormal vital signs of SIRS were referred more often, decreased oxygen saturation, hypotension and rapid illness progression seem to be most important for GPs to guide further management.

Abstract Image

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
在非工作时间的初级保健中出现急性感染的成年患者的全身炎症反应综合征的生命体征:一项横断面研究。
背景:全身性炎症反应综合征(SIRS)的体征——发烧(或体温过低)、心动过速和呼吸急促——在医院被用来识别可能的败血症患者。目的:确定在疑似感染的成人非工作时间(OOH)初级保健患者中SIRS生命体征异常的频率,并评估其与急性医院转诊的关系。方法:2015年8月至10月,我们在荷兰奈梅亨的户外GP合作社进行了一项横断面研究。指示全科医生记录所有疑似急性感染患者的体温、心率和呼吸频率。回顾性提取户外GP合作电子登记系统中SIRS的生命体征、其他相关体征、症状及转诊状态。采用Logistic回归分析评估临床体征与医院转诊的关系。结果:共纳入疑似感染患者558例。在门诊就诊的35/409(8.6%)和家访的60/149(40.3%)中,至少有2项SIRS生命体征异常。转诊率从没有SIRS生命体征异常时的13%上升到三个SIRS生命体征均异常时的68%。转诊与血氧饱和度降低、低血压和疾病进展迅速相关,但与个体SIRS生命体征无关。结论:虽然SIRS生命体征异常患者的转诊频率更高,但血氧饱和度降低、低血压和病情进展迅速似乎是全科医生指导进一步治疗的最重要因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
European Journal of General Practice
European Journal of General Practice PRIMARY HEALTH CARE-MEDICINE, GENERAL & INTERNAL
CiteScore
5.10
自引率
5.90%
发文量
31
审稿时长
>12 weeks
期刊介绍: The EJGP aims to: foster scientific research in primary care medicine (family medicine, general practice) in Europe stimulate education and debate, relevant for the development of primary care medicine in Europe. Scope The EJGP publishes original research papers, review articles and clinical case reports on all aspects of primary care medicine (family medicine, general practice), providing new knowledge on medical decision-making, healthcare delivery, medical education, and research methodology. Areas covered include primary care epidemiology, prevention, diagnosis, pharmacotherapy, non-drug interventions, multi- and comorbidity, palliative care, shared decision making, inter-professional collaboration, quality and safety, training and teaching, and quantitative and qualitative research methods.
期刊最新文献
Democratising the design and delivery of large-scale randomised, controlled clinical trials in primary care: A personal view. Diagnostic flow for all patients referred with non-specific symptoms of cancer to a diagnostic centre in Denmark: A descriptive study. Monitoring COVID-19 in Belgian general practice: A tool for syndromic surveillance based on electronic health records. Evaluation of the psychometric performance of the Spanish and Catalan versions of the patient reported experiences and Outcomes of Safety in Primary Care (PREOS-PC)-Compact questionnaire. The experiences of transgender and nonbinary adults in primary care: A systematic review.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1