The PIRO concept: P is for predisposition.

As you know, in 1991 the American College of Chest Physicians and the Society of Critical Care Medicine convened a consensus panel to come up with some operational definitions for sick septic patients that would, in particular, facilitate the standardized enrolment of patients into clinical trials.At that time it was proposed to be 'infection' plus two or three out of the four systemic inflammatory response syndrome (SIRS) criteria that were believed to be related to the infection.If you also had acute organ dysfunction, it was believed that you had severe sepsis.That was published in 1992 and served as the basis for enrolment entry criteria into about 30 large randomized, controlled trials, but it rarely did much in terms of patient management -people were not necessarily using it to care for patients.