What is SIRS?
SIRS is the abbreviation of Systemic inflammatory response syndrome. It is the body’s response (patients’s reaction) related to critical illness of systemic inflammation, organ dysfunction, and organ failure and in some cases it can develop in many noninfectious conditions (major trauma, major surgery, burns, necrotizing pancreatitis).
SIRS and Sepsis :
Sepsis is SIRS resulting from a presumed or known site of infection. It is the body’s life-threatening response to infection that can lead to tissue damage, organ failure, and even death.
Sometimes our immune system which normally fights the germs to prevent the infections, stops fighting and begins to turn on itself. This is the beginning of sepsis. It needs rapid diagnosis and immediate medical attention. Without the proper treatment sepsis can lead to severe sepsis(one or more end organ failure) and septic shock (inability of blood flow to tissues and organs).
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)
SIRS Analysis in Sepsis patients dataset :
The dataset that has been analyzed here consists of 43 parameters, which includes hourly vitals along with patients other details.
If any two of the SIRS symptoms are satisfied, it is considered as the trigger (beginning) hour of SIRS. From the above Pie chart (figure 2) we can see the number of patients who exhibits SIRS symptoms each hour since the admission.
The SIRS symptoms are very crucial. When a patient has high body temperature(fever) and an increased white blood cell count (WBC), these are features of the Acute-phase Reaction. While increased heart rate (HR) is often the initial sign of hemodynamic compromise. An increased rate of breathing (Resp) may be related to the increased metabolic stress due to infection and inflammation, but may also be an ominous sign of inadequate perfusion resulting in the onset of anaerobic cellular metabolism.
From figure 2, we understand that there are 22% of total patients in this data set got admitted with the SIRS symptoms. It is hard to find the time of trigger since many patients may not keep track of the time when they start showing each symptom.
Now let’s filter out the vitals of patients with SIRS symptoms during their first hour of hospital admission. In the above tableau visualization, we see more than 55% patients have High Heart rate and increased metabolic stress (respiratory rate). 2% of the patients are getting admitted with Acute-phase Reaction (High Temperature and High WBC) which could be fatal. We can also see from the data that during the first hour of admission, many patients shows more than 2 SIRS symptoms and in need of immediate medical attention.
The number of new SIRS patients reduces over the time they are being admitted. ie the percentage of patients getting SIRS symptoms drops below 3% after the patients are being admitted over 10 hours and the percentage keeps on dropping over the time.
In figure 4 , we have the comparison of patients vitals during the SIRS trigger hour and 1 hour before the SIRS trigger. Please click here for the interactive comparison dashboard. Using the above comparison we can see how patients constantly develop the symptoms of SIRS. Here in this dataset, patient ID 3 had high respiratory rate in his first hour of getting admitted and has developed High heart rate in his 2nd hour which resulted in satisfying 2 SIRS symptoms. Using this study, we can create an email alert system using tableau to alert the doctors when there is a continuous increase in any of the above vitals or combination of vitals to prioritize the patients care. Conclusion : The SIRS criteria are guidelines set in place to ensure sepsis patients receive care as early as possible. It is crucial to diagnose the SIRS symptoms at the earliest to provide the proper treatment. May be not all SIRS patients have sepsis but all sepsis patients have SIRS. References : https://www.kaggle.com/code/namratakapoor1/sepsis-classification/data https://www.sciencedirect.com/topics/nursing-and-health-professions/systemic-inflammatory-response-syndrome