PIRO and sepsis stratification: reality or a mirage? - Critical Care Science (CCS)
The objectives of staging systems are to stratify patients with a given disease according to their risk for adverse events, to assess their potential response to a given treatment, and to monitor their actual response. Such systems are widely used, and the Classification of Malignant Tumors (TNM) is the best-known of these systems.() In oncology, staging of neoplasms is an essential step in the process of clinical decision-making, as it is crucial for the establishment of the prognosis of the disease and the choice of the most adequate therapeutic approach.()
The concepts of infection, systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic shock defined at the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) Consensus Conference represented the first attempt at the stratification of sepsis.() The fact that the mortality of septic patients increases in parallel to the number of SIRS criteria that they meet was noticed very early, as was its correlation with the presence of organ failure (severe sepsis) and, in particular, septic shock, which exceeded 50% in the original studies.()
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The objectives of staging systems are to stratify patients with a given disease according to their risk for adverse events, to assess their potential response to a given treatment, and to monitor their actual response. Such systems are widely used, and the Classification of Malignant Tumors (TNM) is the best-known of these systems.() In oncology, staging of neoplasms is an essential step in the process of clinical decision-making, as it is crucial for the establishment of the prognosis of the disease and the choice of the most adequate therapeutic approach.()
The concepts of infection, systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic shock defined at the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) Consensus Conference represented the first attempt at the stratification of sepsis.() The fact that the mortality of septic patients increases in parallel to the number of SIRS criteria that they meet was noticed very early, as was its correlation with the presence of organ failure (severe sepsis) and, in particular, septic shock, which exceeded 50% in the original studies.()
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