ArticleThe New England journal of medicine2015
Systemic inflammatory response syndrome criteria in defining severe sepsis.
Article in The New England journal of medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 507 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Assessing Targeted Fluid Resuscitation Strategies Among Patients With Severe Sepsis and Septic Shock
Predict Sepsis; the Predictive Value of Bedside Measures in the Ambulance
Who cites it
507 citing papers in PubMed, 3 syntheses or guidelines pooled it, 1,161 citations in OpenAlex.
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Cell-free DNA as diagnostic and prognostic biomarkers for adult sepsis: a systematic review and meta-analysis.Scientific reports · 2023Pooled it
- The Key Drivers of Brain Injury by Systemic Inflammatory Responses after Sepsis: Microglia and Neuroinflammation.Molecular neurobiology · 2023Pooled it
- Integrated host-microbe plasma metagenomics for sepsis diagnosis in a prospective cohort of critically ill adults.Nature microbiology · 2022Trial
- Disease-Stage Synchronized Nanozyme Therapy for Polymicrobial Sepsis through Adaptive Catalytic and Immune Reprogramming.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Short-Chain Fatty Acids in Sepsis: Mechanisms of Action and Therapeutic Advances.Biomedicines · 2026Review
- Evaluation of Sepsis Algorithmic Alerts Among Hospitalized Pediatric Patients in Qatar: A Retrospective Cohort Study.Health science reports · 2026Article
- The phoenix sepsis score for high mortality risk identification and prognostic predict in pediatric liver transplant recipients.European journal of pediatrics · 2026Article
- How infection affects the relationship between leukocyte count and mortality risk in intensive care.Infection · 2026Article
- Juglone Protects Against CLP-Induced Sepsis by Regulating Apoptosis, Pyroptosis, and Oxidative Stress Mechanisms.Pharmaceuticals (Basel, Switzerland) · 2026Article
- High-dose ceftriaxone: Pharmacokinetic and pharmacodynamic insights in hospitalized patients with suspected sepsis in Thailand.British journal of clinical pharmacology · 2026Article
- ERK/Smurf1 regulates non-canonical pyroptosis by prompting Caspase-11 ubiquitination.Cell death and differentiation · 2026Article
- Mucosal-associated invariant T (MAIT) cells are reduced and dysfunctional in acute melioidosis.Scientific reports · 2026Article
- The A-VIVO score: a novel prognostic tool for predicting mortality in patients with sepsis.Irish journal of medical science · 2026Article
- Recent advances in the biosensing platforms for sepsis diagnosis.RSC advances · 2026Review
- J-shaped association between serum bicarbonate and 28-day ICU mortality in adult patients with sepsis: A multicenter cohort analysis.Medicine · 2026Article
- Diagnosing Sepsis in Primary Care: Navigating Clinical Uncertainty Across Vulnerable Patient Groups.Cureus · 2026Review
- Development and validation of a bacteremia prediction score for adult emergency department patients using hybrid machine learning and regression.Scientific reports · 2026Article
- Association of Triglyceride-to-HDL-C Ratio, Triglyceride-Glucose Index, and Inflammatory Biomarkers with Mortality in Intensive Care Unit Patients with Sepsis.Diagnostics (Basel, Switzerland) · 2026Article
- Modified SIRS Criteria for Patients ≥ 65 Years with Addition of Altered Mental Status and Reduced Heart Rate for Atrioventricular Nodal Blockers.The western journal of emergency medicine · 2026Observational
447 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe consensus definition of severe sepsis requires suspected or proven infection, organ failure, and signs that meet two or more criteria for the systemic inflammatory response syndrome (SIRS). We aimed to test the sensitivity, face validity, and construct validity of this approach.
methodsWe studied data from patients from 172 intensive care units in Australia and New Zealand from 2000 through 2013. We identified patients with infection and organ failure and categorized them according to whether they had signs meeting two or more SIRS criteria (SIRS-positive severe sepsis) or less than two SIRS criteria (SIRS-negative severe sepsis). We compared their characteristics and outcomes and assessed them for the presence of a step increase in the risk of death at a threshold of two SIRS criteria.
resultsOf 1,171,797 patients, a total of 109,663 had infection and organ failure. Among these, 96,385 patients (87.9%) had SIRS-positive severe sepsis and 13,278 (12.1%) had SIRS-negative severe sepsis. Over a period of 14 years, these groups had similar characteristics and changes in mortality (SIRS-positive group: from 36.1% [829 of 2296 patients] to 18.3% [2037 of 11,119], P<0.001; SIRS-negative group: from 27.7% [100 of 361] to 9.3% [122 of 1315], P<0.001). Moreover, this pattern remained similar after adjustment for baseline characteristics (odds ratio in the SIRS-positive group, 0.96; 95% confidence interval [CI], 0.96 to 0.97; odds ratio in the SIRS-negative group, 0.96; 95% CI, 0.94 to 0.98; P=0.12 for between-group difference). In the adjusted analysis, mortality increased linearly with each additional SIRS criterion (odds ratio for each additional criterion, 1.13; 95% CI, 1.11 to 1.15; P<0.001) without any transitional increase in risk at a threshold of two SIRS criteria.
conclusionsThe need for two or more SIRS criteria to define severe sepsis excluded one in eight otherwise similar patients with infection, organ failure, and substantial mortality and failed to define a transition point in the risk of death. (Funded by the Australian and New Zealand Intensive Care Research Centre.).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.