The Reply

Abstract

We thank Drs. Zhou and Tang for their comments on our article "Does Use of Electronic Alerts for Systemic Inflammatory Response Syndrome (SIRS) to Identify Patients With Sepsis Improve Mortality?" 1 In response to their first question, the authors are correct that 23% of patients received antibiotics before the firing of the best practice alert. These patients did not meet the SIRS with organ dysfunction criteria at the time of antibiotic administration and were thus not included in our cohort. They would likely not have met the criteria for Sepsis-2 used in Seymour's study. 2 We appreciate the comments about the total number of patients in the various subcategories in Table 3. The variation in number is as a result of a low percentage of missing data for that variable. In our study, there were 21 admissions in which the age of the patients was missing in the electronic medical record (0.23%) and 44 admissions in which blood pressure at the time of the first firing of the SIRS Best Practice Alert was missing (0.48%).Lastly, we agree that the relationship between gender and mortality needs to be explored further. We stand by the conclusions of our cohort of over 8000 patients but recognize that socioeconomic and geographic differences may play a role in any sample that is studied.We thank the authors for their thoughtful comments.