Systemic inflammatory response syndrome in tissue-type plasminogen activator-treated patients is associated with worse short-term functional outcome

Stroke. 2013 Aug;44(8):2321-3. doi: 10.1161/STROKEAHA.113.001371. Epub 2013 May 23.

Abstract

Background and purpose: Systemic inflammatory response syndrome (SIRS) is a generalized inflammatory state. The primary goal of the study was to determine whether differences exist in outcomes in SIRS and non-SIRS intravenous tissue-type plasminogen activator-treated patients.

Methods: Consecutive patients were retrospectively reviewed for the evidence of SIRS during their admission. SIRS was defined as the presence of ≥2 of the following: body temperature<36°C or >38°C, heart rate>90, respiratory rate>20, and white blood cells<4000/mm or >12 000 mm, or >10% bands. Patients diagnosed with infection (via positive culture) were excluded.

Results: Of the 241 patients, 44 had evidence of SIRS (18%). Adjusting for pre-tissue-type plasminogen activator National Institutes of Health Stroke Scale, age, and race, SIRS remained a predictor of poor functional outcome at discharge (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.16-5.73; P=0.0197).

Conclusions: In our sample of tissue-type plasminogen activator-treated (tPA) patients, ~1 in 5 patients developed SIRS. Furthermore, we found the presence of SIRS to be associated with poor short-term functional outcomes and prolonged length of stay.

Keywords: inflammation; ischemic stroke; stroke care; tPA.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Administration, Intravenous
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Systemic Inflammatory Response Syndrome / epidemiology*
  • Systemic Inflammatory Response Syndrome / mortality
  • Thrombolytic Therapy / methods*
  • Time Factors
  • Tissue Plasminogen Activator / administration & dosage*
  • Treatment Outcome
  • Young Adult

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator