Journal Article

Systemic Inflammation Evaluated by Interleukin-6 or C-Reactive Protein in Critically Ill Patients: Results From the FROG-ICU Study

de Roquetaillade, Charles, Davison, Beth A., Picod, Adrien, Morisson, Louis, Sadoune, Malha, Gayat, Etienne, Chousterman, Benjamin Glenn, Cotter, Gad, Mebazaa, Alexandre

2022

Overview

The prognostic impact of high concentration of interleukin-6 (IL-6) or C-reactive protein (CRP), two routinely available markers of systemic inflammation in the general population of critically ill patients, remains unclear. In a large cohort of critically ill patients including septic and non-septic patients, we assessed the relationship between baseline IL-6 or CRP and mortality, organ dysfunction, and the need for organ support. This was an ancillary analysis of the prospective French and euRopean Outcome reGistry in Intensive Care Units (FROG-ICU) study including patients with a requirement for invasive mechanical ventilation and/or vasoactive drug support for more than 24 h following intensive care unit (ICU) admission. The primary objective was to determine the association between baseline IL-6 or CRP concentration and survival until day 90. Secondary outcomes included organ dysfunction as evaluated by the Sequential Organ Failure Assessment (SOFA) score, and the need for organ support, including vasopressors/inotropes and/or renal replacement therapy (RRT). Median IL-6 and CRP concentrations ( = 2,076) at baseline were 100.9 pg/ml (IQR 43.5-261.7) and 143.7 mg/L (IQR 78.6-219.8), respectively. Day-90 mortality was 30%. High IL-6 or CRP was associated with worse 90-day survival (hazard ratios 1.92 [1.63-2.26] and 1.21 [1.03-1.41], respectively), after adjustment on the Simplified Acute Physiology Score II (SAPS-II). High IL-6 was also associated with the need for organ-support therapies, such as vasopressors/inotropes (OR 2.67 [2.15-3.31]) and RRT (OR 1.55 [1.26-1.91]), including when considering only patients independent from those supports at the time of IL-6 measurement. Associations between high CRP and organ support were inconsistent. IL-6 appears to be preferred over CRP to evaluate critically ill patients' prognoses.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: Biomarkers / C-reactive protein / critical illness / Cytokines / Disease / Heart failure / Immunology / Inflammation / Intensive care / Intensive care units / Interleukin 6 / Mechanical ventilation / Medical prognosis / Mortality / Patients / Plasma / Population / Regression analysis / Sepsis / Sequential organ failure assessment / Simplified Acute Physiology Score / Survival / Vasoactive agents / Ventilators