Journal Article

Diagnostic and prognostic value of interleukin-6, pentraxin 3, and procalcitonin levels among sepsis and septic shock patients: a prospective controlled study according to the Sepsis-3 definitions

Park, Jong Hak, Park, Dae Won, Song, Juhyun, Cho, Han-Jin, Choi, Won Seok, Moon, Sungwoo, Seok, Hyeri

2019

Overview

Background This study investigated the clinical value of interleukin-6 (IL-6), pentraxin 3 (PTX3), and procalcitonin (PCT) in patients with sepsis and septic shock diagnosed according to the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Methods Serum levels of IL-6, PTX3, and PCT were measured in 142 enrolled subjects (51 with sepsis, 46 with septic shock, and 45 as controls). Follow-up IL-6 and PTX3 levels were measured in patients with initial septic shock within 24 h of hospital discharge. Optimal cut-off values were determined for sepsis and septic shock, and prognostic values were evaluated. Results Serum IL-6 levels could discriminate sepsis (area under the curve [AUC], 0.83–0.94, P  <  0.001; cut-off value, 52.60 pg/mL, 80.4% sensitivity, 88.9% specificity) from controls and could distinguish septic shock (AUC, 0.71–0.89; cut-off value, 348.92 pg/mL, 76.1% sensitivity, 78.4% specificity) from sepsis. Twenty-eight-day mortality was significantly higher in the group with high IL-6 (≥ 348.92 pg/mL) than in the group with low IL-6 (< 348.92 pg/mL) ( P  = 0.008). IL-6 was an independent risk factor for 28-day mortality among overall patients (hazard ratio, 1.0004; 95% confidence interval, 1.0003–1.0005; p  = 0.024). In septic shock patients, both the initial and follow-up PTX3 levels were consistently significantly higher in patients who died than in those who recovered (initial p  = 0.004; follow-up P  <  0.001). Conclusions The diagnostic and prognostic value of IL-6 was superior to those of PTX3 and PCT for sepsis and septic shock.

• Publisher: BioMed Central,BioMed Central Ltd,BMC
• Subject: Adult / Aged / Aged, 80 and over / Area Under Curve / Bacterial and fungal diseases / Biomarkers - blood / C-Reactive Protein - analysis / Case-Control Studies / Emergency department / Female / Hospital admission and discharge / Humans / Infection / Infectious Diseases / Interleukin-6 / Interleukin-6 - blood / Interleukins / Internal Medicine / Male / Medical Microbiology / Medical research / Medicine / Medicine & Public Health / Middle Aged / Mortality / Parasitology / Pentraxin 3 / Procalcitonin / Procalcitonin - blood / Prognosis / Research Article / Risk Factors / ROC Curve / Sensitivity and Specificity / Sepsis / Sepsis - diagnosis / Sepsis - mortality / Sepsis - pathology / Septic shock / Serum Amyloid P-Component - analysis / Severity of Illness Index / Shock / Shock, Septic - diagnosis / Shock, Septic - mortality / Shock, Septic - pathology / Tropical Medicine