Different patient case mix by applying the 2003 SCCM/ESICM/ACCP/ATS/SIS sepsis definitions instead of the 1992 ACCP/SCCM sepsis definitions in surgical patients: a retrospective observational study

Table 1 Diagnostic criteria and organ dysfunction variables within the 1992 ACCP/SCCM and the 2003 SCCM/ESICM/ACCP/ATS/SIS sepsis definitions

	ACCP/SCCM 1992	SCCM/ESICM/ACCP/ATS/SIS 2003
Diagnostic criteria for sepsis
Infection	+	+
Temperature	<36.0°C and/or >38.0°C	<36.0°C and/or >38.3°C
Heart rate	>90	>90
Respiratory rate	>20	>30
White blood cell count (WBC)	>12,000/μl and/or <4,000/μl and/or >10% immature	>12,000/μl and/or <4,000/μl and/or >10% immature
Altered mental status	n. a.	+
Significant edema	n. a.	+
Positive fluid balance	n. a.	>20 ml/kg over 24 hrs
Hyperglycemia in absence of diabetes	n. a.	>120 mg/dl or 7.7 mmol/l
Plasma C-reactive protein	n. a.	>2 SD above normal
Plasma procalcitonin	n. a.	>2 SD above normal
SvO₂	n. a.	>70%
Cardiac index	n. a.	>3.5 l/min/m²
Organ dysfunction variables
Altered mental status	+	n. a.
Lactic acidosis	+	n. a.
Acute oliguria	<500 ml/24 h	<0.5 ml/kg/h or 45 mmol/l >2 h
Hypoperfusion or hypotension	+	+
SOFA score	>2	n. a.
Creatinine	n. a. >3.5 mg/dl or 300 μmol/l*	n. a.
Creatinin increase	n. a.	>0.5 mg/dl or 43 μmol/l
Arterial hypoxemia	n. a. PaO₂/FiO₂ <= 200 with respiratory support*	PaO₂/FiO₂ < 300
Coagulation abnormalities	n. a.	INR > 1.5 or aPTT > 60s
Ileus (absent bowel sounds)	n. a.	+
Thrombocytopenia, platelet count	n. a. <= 50,000/μl*	<100,000/μl
Hyperbilirubinemia, plasma total bilirubin	n. a. >6 mg/dl or 102 μmol/l*	>4 mg/dl or 70 μmol/l
Hyperlactatemia	n. a.	>1 mmol/l

n. a. = not applicable, INR = International Normalized Ratio, PaO₂/FiO₂ = partial pressure of arterial oxygen/fraction of inspired oxygen, SOFA = Sequential Organ Failure Assessement, SvO₂ = mixed venous oxygen saturation, *according to the definition of organ dysfunction with greater than 2 points in the SOFA score.

ISSN: 1472-6947