Factors Predicting Systemic Inflammatory Response Syndrome in Cranial Surgery Patients

  • เบญจกาย ตรีถูกแบบ yes
  • วัลย์ลดา ฉันท์เรืองวณิชย์
  • อรพรรณ โตสิงห์
  • ธีรพล วิทธิเวช
Keywords: systemic inflammatory response syndrome, craniotomy, blood glucose, comorbidity, age


     Objective: To study the predicting power of age, comorbidity, blood glucose and types of surgery on cranial surgery patients systemic inflammatory response syndrome (SIRS).
     Design: Predictive correlational research.
     Methodology: The sample consisted of 164 cranial surgery patients in the intensive care unit of a tertiary hospital. The study was conducted within the frst 24 hours after their operations. The research instruments were 1) a personal information form; 2) a comorbidity assessment form; and 3) a systemic inflammatory response syndrome (SIRS) scoring form. Binary Logistic Regression Analysis was employed for data analysis, with the level of statistical signifcance set at .05.
     Results: The incidence of SIRS was found in 49.4% of the patients. Age and blood glucose levels were identifed as signifcant factors capable of predicting 24% of SIRS incidence (at .05, Nagelkerke R2 = .24, p < .01). Comorbidity and surgery types, on the other hand, were incapable of signifcantly predicting SIRS.
     Recommendations: It is recommended that nurses apply the data on every cranial surgery patients age, blood glucose level and SIRS score to assessing their post-operative condition, as part of the process of monitoring all the risk-group patients for clinical signs of inflammation and alleviating their systemic inflammation.


Download data is not yet available.


1.Boehme AK, Hays AN, Kicielinski KP, Arora K, Kapoor N, Lyerly MJ, et al. Systemic inflammatory response syndrome and outcomes in intracerebral hemorrhage. Neurocrit Care 2016;25(1):133-40.
2. Tam AK, Ilodigwe D, Mocco J, Mayer S, Kassell N, Ruefenacht D, et al. Impact of systemic inflammatory
response syndrome on vasospasm, cerebral infarction, and outcome after subarachnoid hemorrhage: exploratory analysis of CONSCIOUS-1 database. Neurocrit Care 2010;13(2):182-9.
3. Singer M, Deutschman CS, Seymour CW, ShankarHari M, Annane D, Bauer M, et al. The third international consensus defnitions for sepsis and septic shock (Sepsis-3). JAMA 2016; 315(8):801-10.
4. Chao A, Chou W-H, Chang C-J, Lin Y, Jr., Fan S-Z, Chao A-S. The admission systemic inflammatory
response syndrome predicts outcome in patients undergoing emergency surgery. Asian J Surg 2013; 36(3):99-103.
5. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference:defnitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 1992;20(6):864-74.
6. Dieleman JM, Peelen LM, Coulson TG, Tran L, Reid CM, Smith JA, et al. Age and other perioperative
risk factors for postoperative systemic inflammatory response syndrome after cardiac surgery. Br J Anaesth 2017;119(4):637-44.
7. Kulpho Y, Thosingha O, Danaidutsadeekul S, Kongsayreepong S. Predicting factors for systemic inflammatory response syndrome during the frst 24 post-operative hours in abdominal surgery patients. Thai J Nurs Res 2014;29(1):5 -14. (In Thai)
8. Chaikittisilpa N, Krishnamoorthy V, Lele AV, Qiu Q, Vavilala MS. Characterizing the relationship between systemic inflammatory response syndrome and early cardiac dysfunction in traumatic brain injury. J Neurosci Res 2018;96(4):661-70.
9. Srivisai T, Pinyopasakul W, Charoenkitkarn V. Relationships between age, body mass index, comorbidity and systemic inflammatory response syndrome in patients with respiratory infection at an emergency unit. Rama Nurs J 2558;21(2):186 - 98. (In Thai)
10. Bhattacharjee S, Layek A, Maitra S, Sen S, Pal S, Gozi NK. Perioperative glycemic status of adult traumatic
brain injury patients undergoing craniotomy: a prospective observational study. J Neurosurg Anesthesiol 2014;26(4):313-9.
11. Chen S, Li Q, Wu H, Krafft PR, Wang Z, Zhang JH. The harmful effects of subarachnoid hemorrhage on
extracerebral organs. Biomed Res Int. 2014;2014:858496. doi: 10.1155/2014/ 858496.
12. Saetung H, Thosingha O, Danaidutsadeekul S,Tantiwongkosri K. Relationship between blood loss, blood glucose level and serum magnesium level and multiple-organ dysfunction within the frst 24 hours after open-heart surgery. Thai J Nurs Res 2014;29(3):80-91. (In Thai)
13. Alazawi W, Pirmadjid N, Lahiri R, Bhattacharya S. Inflammatory and immune responses to surgery and
their clinical impact. Ann Surg 2016;264(1):73-80.
14. Ramona Browder Lazenby. Handbook of pathophysiology. 4 ed. China: Wolters Kluwer Health; 2011.
15. Chen S, Yang Q, Chen G, Zhang JH. An update on inflammation in the acute phase of intracerebral
hemorrhage. Transl Stroke Res 2015;6(1):4-8.
16. Alan N, Seicean A, Seicean S, Neuhauser D, Weil RJ. Impact of preoperative anemia on outcomes in
patients undergoing elective cranial surgery. J Neurosurgery 2014;120(3):764-72.111
17. Fernandes D, Goncalves-Pereira J, Janeiro S, Silvestre J, Bento L, Povoa P. Acute bacterial meningitis in the
intensive care unit and risk factors for adverse clinical outcomes: retrospective study. Journal of critical care
18. Jafar N, Edriss H, Nugent K. The effect of short-term hyperglycemia on the innate immune system. Am J
Med Sci 2016;351(2):201-11.
19. Finnerty CC, Mabvuure NT, Ali A, Kozar RA, Herndon DN. The surgically induced stress response. JPEN J
Parenter Enteral Nutr 2013;37(5 Suppl): 21s-9s.
20. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation
and regression analyses. Behav Res Methods 2009;41(4):1149-60.
21. Jacome T, Tatum D. Systemic inflammatory response syndrome (SIRS) score independently predicts poor
outcome in isolated traumatic brain injury. Neurocrit Care 2018;28(1):110-6.
22. Charlson Mary E., Charlson Robert E., Peterson Janey C., Marinopoulos Spyridon S., Briggs William M.,
Hollenberg James P. The Charlson comorbidity index is adapted to predict costs of chronic disease in primary
care patients. J Clin Epidemiol 2008;61(12): 1234-40.
23. Baek JH, Kim MS, Lee JC, Lee JH. Systemic inflammation response syndrome score predicts the
mortality in multiple trauma patients. Korean J Thoracic Cardiovascular Surg 2014;47(6):523-8.
24. Maneeprasit M, Sindhu S, Danaidutsadeekul S, Tantiwongkosri K. Factors related to systemic
inflammatory response syndrome (SIRS) of coronary artery disease patients in the frst 24 hours after open
heart surgery. JRTAN 2016;17(3):63-72.
25. Schifman RB, Howanitz PJ, Souers RJ. Point-of-care glucose critical values: A Q-Probes study involving
50 health care facilities and 2349 critical results. Arch Pathol Lab Med 2016; 140 (2):119-24.
26. Niven DJ, Rubenfeld GD, Kramer AA, Stelfox HT. Effect of published scientifc evidence on glycemic
control in adult intensive care units. JAMA Intern Med 2015;175(5):801-9.
27. Scott MJ, Miller TE. Pathophysiology of Major Surgery and the Role of Enhanced Recovery Pathways
and the Anesthesiologist to Improve Outcomes. Anesthesiol Clin 2015;33(1):79-91.
28. Dieleman JM, Nierich AP, Rosseel PM, van der Maaten JM, Hofland J, Diephuis JC, et al. Intraoperative highdose dexamethasone for cardiac surgery: a randomized controlled trial. JAMA 2012;308(17): 1761-7.
29. Lineberry C, Stein DE. Infection, sepsis, and immune function in the older adult receiving critical care. Crit
Care Nurs Clin North Am 2014;26(1):47-60.
30. Rau C-S, Wu S-C, Chen Y-C, Chien P-C, Hsieh H-Y, Kuo P-J, et al. Stress-induced hyperglycemia, but
not diabetic hyperglycemia, is associated with higher mortality in patients with isolated moderate and
severe traumatic brain injury: analysis of a propensity score-matched population. Int J Environ Res Public
Health 2017;14(11):1340.
31. Daniel R, Villuri S, Furlong K. Management of hyperglycemia in the neurosurgery patient. Hosp Pract 2017;45(4):150-7.
32. Bilotta F, Rosa G. Optimal glycemic control in neurocritical care patients. Crit Care 2012;16(5):163.
33. Golebiowski A, Drewes C, Gulati S, Jakola AS, Solheim O. Is duration of surgery a risk factor for extracranial complications and surgical site infections after intracranial tumor operations? Acta Neurochir
34. Davis MC, Ziewacz JE, Sullivan SE, El-Sayed AM. Preoperative hyperglycemia and complication risk
following neurosurgical intervention: a study of 918 consecutive cases. Surg Neurol Int 2012;3:49.
How to Cite
ตรีถูกแบบเ, ฉันท์เรืองวณิชย์ว, โตสิงห์อ, วิทธิเวชธ. Factors Predicting Systemic Inflammatory Response Syndrome in Cranial Surgery Patients. TJNC [Internet]. 2019Apr.23 [cited 2020Aug.11];34(2):94-111. Available from: https://he02.tci-thaijo.org/index.php/TJONC/article/view/159993