The independent predictors of 3-day mortality in patients with systemic inflammatory response syndrome in emergency department.

Objective To study the independent predictors of 3-day mortality of patients with systemic in-flammatory response syndrome(SIRS) in emergency department. Method From Dec 2006 to Sep 2007, 640 pa-tients with SIRS admitted to emergency department were enrolled. Those died within one hour were excluded. Ev-ery patient was examined on plasma B-type natriuretie peptide (BNP) level and serum cardiac Troponin Ⅰ (cTNI) level. Early warning score (EWS) was calculated. Rank test was used to compare the difference of BNP,cTNI and EWS between survivors and non-survivors. Logistic regression analysis was used to determine the independent pre-dictors for death and receiver operator characteristic curve was used to determine the cutoff values. Results The mean levels of age, BNP, cTNI and EWS of patients died in 3 days were 73.5(65～80),468.5 pg/mL(161.5～1862.5 pg/mL),0.37 ng/mL(0.07～2.61 ng/mL) and 6(5～9), respectively. In survivors, the mean levels of age, BNP, cTNI and EWS were 71(60～77), 239 pg/mL(56.3～783.8 pg/mL), 0.07 ng/mL(0.03～0.26 ng/mL)and 4(3～6), respectively. There were significant difference in age, BNP, cTNI and EWS between two groups (P < 0.05). Age ≥ 76, BNP ≥ 115 pg/mL, cTNI ≥ 0.135 ng/mL and EWS ≥ 6 were independent predic-tors of death. Conclusions Levels of BNP,cTNI and EWS were predictors of death in SIRS patients during emer-gency department stay. Key words: Systemic inflammatory response syndrome; B-type natriuretic peptide;  Cardiac troponin Ⅰ; Early wanting score;  Prognosis