• Manfred Weiss, Markus Huber-Lang, Michael Taenzer, Martina Kron, Birgit Hay, Maximilian Nass, Moritz Huber, and Marion Schneider.
• Department of Anaesthesiology, University Hospital Medical School Ulm, Steinhoevelstr, 9, 89075 Ulm, Germany. manfred.weiss@uniklinik-ulm.de.
• BMC Anesthesiol. 2010 Dec 21; 10: 22.

BackgroundIt has never been specified how many of the extended general and inflammatory variables of the 2003 SCCM/ESICM/ACCP/ATS/SIS consensus sepsis definitions are mandatory to define sepsis.ObjectivesTo find out how many of these variables are needed to identify almost all patients with septic shock.MethodsRetrospective observational single-centre study in postoperative/posttraumatic patients admitted to an University adult ICU. The survey looked at 1355 admissions, from 01/2007 to 12/2008, that were monitored daily computer-assisted for the eight general and inflammatory variables temperature, heart rate, respiratory rate, significant edema, positive fluid balance, hyperglycemia, white blood cell count and C-reactive protein. A total of 507 patients with infections were classified based on the first day with the highest diagnostic category of sepsis during their stay using a cut-off of 1/8 variables compared with the corresponding classification based on a cut-off of 2, 3, 4, 5, 6, 7 or 8/8 variables.ResultsApplying cut-offs of 1/8 up to 8/8 variables resulted in a decreased detection rate of cases with septic shock, i.e., from 106, 105, 103, 93, 65, 21, 3 to 0. The mortality rate increased up to a cut-off of 6/8 variables, i.e., 31% (33/106), 31% (33/105), 31% (32/103), 32% (30/93), 38% (25/65), 43% (9/21), 33% (1/3) and 0% (0/0).ConclusionsFrequencies and mortality rates of diagnostic categories of sepsis differ depending on the cut-off for general and inflammatory variables. A cut-off of 3/8 variables is needed to identify almost all patients with septic shock who may benefit from optimal treatment.

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