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SIRS (Systemic Inflammatory Response Syndrome) and Sepsis share a complex relationship in the realm of critical illness. Sepsis, a life-threatening condition, is essentially SIRS triggered by a infection. It’s when our immune system, which typically guards against germs, takes an alarming turn and starts attacking the body’s own tissues. Sepsis is the ominous beginning of this self-directed immune response, and it demands swift diagnosis and immediate medical intervention. Without timely and appropriate treatment, sepsis can escalate into severe sepsis, where one or more vital organs may fail, and ultimately, septic shock can occur, characterized by a dire inability of blood to reach essential tissues and organs. This intricate interplay underscores the urgency of recognizing and addressing the signs of sepsis, as its progression can swiftly lead to major consequences. Early detection and intervention are crucial in the battle against this life-threatening condition.
SIRS
SIRS Symptoms :
SIRS can be diagnosed if any of the two following conditions are satisfied.
Temperature >38ºC and < 35ºC Heart Rate >90 beats / minute Respiratory Rate >20 breaths /minute OR PaCo2< 32 torr WBC >12,000 cells/mm3 or < 4000 cells/mm3, or >10 percent immature (band) forms (leukocytosis or leukopenia)
Analyzing the SIRS with Sepsis Data using Tableau:
Let’s take a closer look at the dataset. The Sepsis dataset has 43 biomarkers which can broadly be classified as Demographics, Vital Signs or Clinical, Laboratory values. Similar to biomarkers, patients can be categorized into three distinct conditions:
Patients without sepsis, on admission (Sepsis Label 0).
Patients without sepsis on admission, but later developed Sepsis in ICU (Sepsis Label 0 to 1). we can call them Onset Sepsis patients.
Patients with sepsis, on admission (Sepsis Label 1).
Considering these facts, out of a total patient count of 40,336 a substantial 24,271 patients exhibit SIRS symptoms. (Ref Pic 1 :Donut chart for reference)
Pic 1: SIRS
Below the tableau table created based on SIRS symptoms (as explained above), I introduced an additional dimension called “Previous Hour.” This dimension helps us analyze patients who exhibited SIRS conditions and had the trigger started in the previous hour. When two or more of the SIRS conditions are satisfied, a patient falls under the SIRS criteria, and their trigger is initiated. This information allows us to compare their current status with the previous hour. To enhance clarity, I’ve color-coded the data in the table based on SIRS conditions for both the Trigger Hour and the Previous Hour. This visual representation aids in quickly identifying patients who have shown symptoms and may require prioritized or immediate care based on a holistic assessment of other factors.
Fig 3 Hourly analysis of Biomarkers
Leveraging the insights gained from this study, we have the capability to establish an email alert system using Tableau. This system is designed to proactively notify doctors when there is a consistent escalation in any of the mentioned vital signs or specific vital sign combinations, ensuring the prioritization of patient care without the need to await hourly reports.
How to Trigger Email Alerts in Tableau?
Step 1:
Dashboard -> Action (click)
Step 2:
Click on Add action and then choose “ Go to URL”
Step 3:
Change the Name and then select the sheets, after in that URL
Enter the URL “ mailto:oncall@gmail.com?&subject=Immediate%20attention%20needed&body=Hello Doctor%0D%0ABelow are the patient details%0D%0APatient Id:<SIRS_PATIENTID>%0D%0A HR: <SIRS_EMAILBodyHR> Temp:<SIRS_EMAILBody_TEMP> Resp:<SIRS_EMAILBody_Resp> PaCO2:<SIRS_EMAILBody_PACO2> WBC:<SIRS_EMAILBody_WBC> %0D%0A”
Step 4:
Emails are triggered when the levels of any two biomarkers go out of control.
Conclusion :
SIRS criteria serve as vital guidelines for the early identification and treatment of sepsis patients. Timely diagnosis of SIRS symptoms is paramount to delivering the appropriate medical care. It’s important to acknowledge that while not all individuals meeting the SIRS criteria may ultimately have sepsis, it remains a fundamental fact that all sepsis patients exhibit symptoms consistent with SIRS. This underscores the critical role of SIRS criteria in ensuring that sepsis patients receive the prompt and tailored care they require, ultimately improving their chances of a positive outcome.
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