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American Journal of Critical Care. 2009;18: 339-346 doi:10.4037/ajcc2009267
Copyright © 2009 by the American Association of Critical-Care Nurses.
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CE Article

Systemic Inflammatory Response Syndrome Score and Race As Predictors of Length of Stay in the Intensive Care Unit

By Elizabeth G. NeSmith, RN, MSN, PhD, Sally P. Weinrich, RN, PhD, Jeannette O. Andrews, PhD, APRN, BC, Regina S. Medeiros, RN, MHSA, DNP, CCRN, Michael L. Hawkins, MD and Martin Weinrich, PhD. Elizabeth G. NeSmith is an assistant professor and Sally P. Weinrich is a professor emeritus in the school of nursing at the Medical College of Georgia, Augusta. Jeannette O. Andrews is an associate professor and a senior research scientist in the college of nursing at Medical University of South Carolina in Charleston. Regina S. Medeiros is a trauma program manager at MCGHealth. Michael L. Hawkins is chief of trauma/surgical care in the department of surgery at Medical College of Georgia. Martin Weinrich is a professor emeritus in the department of biostatistics at the Medical College of Georgia.

Corresponding author: Elizabeth G. NeSmith, RN, MSN, PhD, School of Nursing, Medical College of Georgia, Augusta, GA 30912 (e-mail: bnesmith{at}mcg.edu).

Background Identifying predictors of length of stay in the intensive care unit can help critical care clinicians prioritize care in patients with acute, life-threatening injuries.

Objective To determine if systemic inflammatory response syndrome scores are predictive of length of stay in the intensive care unit in patients with acute, life-threatening injuries.

Methods Retrospective chart reviews were completed on patients with acute, life-threatening injuries admitted to the intensive care unit at a level I trauma center in the southeastern United States. All 246 eligible charts from the trauma registry database from 1998 to 2007 were included. Systemic inflammatory response syndrome scores measured on admission were correlated with length of stay in the intensive care unit. Data on race, sex, age, smoking status, and injury severity score also were collected. Univariate and multivariate regression modeling was used to analyze data.

Results Severe systemic inflammatory response syndrome scores on admission to the intensive care unit were predictive of length of stay in the unit (F=15.83; P<.001), as was white race (F=9.7; P=.002), and injury severity score (F=20.23; P<.001).

Conclusions Systemic inflammatory response syndrome scores can be measured quickly and easily at the bedside. Data support use of the score to predict length of stay in the intensive care unit.

Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your understanding of the following objectives:
  1. Identify the significant results found in this study.
  2. Describe practical applications of using the systemic inflammatory response syndrome score.
  3. Discuss further areas of research on this topic.
To read this article and take the CE test online, visit www.ajcconline.org and click "CE Articles in This Issue." No CE test fee for AACN members.


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Clinical Pearls
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Copyright © 2009 by the American Association of Critical-Care Nurses.