You are correct June, and in fact, a mandatory 2/4 SIRS criteria has been removed from the definition of sepsis since the 2001 Sepsis Definitions Conference (Levy CCM 2003). This was further bolstered by the Kaukonen article in NEJM 2015 showing persistently elevated mortality in sepsis patients with 0/4 and 1/4 SIRS criteria. Why CMS would require this non-standard criteria for review is unclear, but clearly omits patients whom clinically meet severe sepsis (now just "sepsis") criteria.
As you probably saw from Lori Harmon's email from SSC, they have responded promptly and adjusted their definitions to align with this landmark article, with no mention of any number of SIRS criteria required for sepsis diagnosis. We can only hope that CMS follows suit. Ryan _______________________________ Ryan Arnold, MD Director of Research, Department of Emergency Medicine Clinical Investigator, Value Institute Christiana Care Health System From: Sepsisgroups [mailto:[email protected]] On Behalf Of June Curry Sent: Monday, February 29, 2016 2:15 PM To: [email protected] Subject: [Sepsis Groups] Feb. 23rd JAMA article negates severe sepsis and SIRS Dr. Townsend, A number of our physicians have brought to our attention an article published by JAMA on Feb. 23rd titled, "The third international consensus definitions for sepsis and septic shock". It is their understanding that this article negates severe sepsis and SIRS. Our physicians are wanting to know when CMS will address these changes and how/when they will affect the current SEP-1 measure. I would appreciate any information you can share that I can pass along to our providers. Thanks! _________________________ June R. Curry, RHIA Manager, Evidence Based Care Process Improvement and Innovation [cid:[email protected]]<http://www.methodisthealth.org/> 1211 Union Ave. Rm 604 Memphis, TN 38104 mobile 901-568-9431 | email [email protected]<mailto:[email protected]>
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