S-SS criteria: Novel criteria for septic shock and new subset septic shock supported with invasive respiration or vasopressor (SIRV)

Purpose: Novel definitions and criteria (S-SS criteria) for diagnosing septic shock via the incorporation of individual organ shock and a subgroup referred to as septic shock supported by invasive respiration and vasopressor (SIRV) were proposed. Methods: 818 patients who visited the hospital because of an infectious cause were enrolled. Individual organ shock was defined as follows: circulatory shock: < 90 mmHg; respiratory shock: PF ratio ≤100; neurologic shock: new onset of altered mentality, excluding hypoglycaemia, intoxication, or drug abuse; and cellular/metabolic shock: serum lactate level ≥4 mmol/L. Per S-SS criteria, septic shock was diagnosed as any of the above parameters. SIRV was diagnosed as any of following: requiring invasive respiratory support or vasopressor support. Primary outcome was in-hospital mortality. Results: 53 (6.5%) patients died prior to hospital discharge. Of the 248 sepsis patients, 30 died (12.1%); of the 32 Sepsis-3 septic shock patients, 16 died (50%); of the 106 S-SS septic shock patients, 28 died (26.4%); and of the 53 Septic shock SIRV patients, 20 died (37.7%). Individual shock criteria showed an acceptable degree of overlap. Conclusion: The distribution and corresponding mortality rates of patients diagnosed with septic shock based on the novel S-SS criteria and Sepsis-3 criteria were evaluated.