Several Cytokines and Protein C Levels with the Apache II Scoring System for Evaluation of Patients with Sepsis.

Abstract:

OBJECTIVE:We investigated whether determination IL-6, IL-8, IL-1beta and TNF-alpha at baseline, total protein C (PC) levels at time of admission and 48 hours after initiation could complement the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system to identify patients with sepsis, severe sepsis or septic shock for clinical outcome. MATERIAL AND METHODS:The study was carried out prospectively. 60 consecutive patients with sepsis, severe sepsis or septic shock were included. Blood samples were obtained at baseline and 48 hours after initiation. Cytokines and PC levels in plasma were measured with an enzyme-linked immunoabsorbent assay (ELISA). APACHE II score was calculated on admission. RESULTS:Baseline IL-6 levels and PC levels 48 hours after initiation were predictive of increased mortality (p=0.016, p=0.044 respectively). Baseline IL-6, IL-8 and TNF-alpha baseline levels correlate with the severity of physiologic insult, as determined by the APACHE II score. However, our multiple logistic regression analysis of these did not reveal any predictive value in combination with the APACHE II score. CONCLUSION:Determination of baseline IL-6 and PC 48 hours after initiation were of predictive value for prognostic evaluation of septic patients, but did not significantly increase predictive power of the APACHE scoring system to identify patients with sepsis for fatal clinical outcome.

journal_name

Balkan Med J

journal_title

Balkan medical journal

authors

Kartal ED,Karkaç E,Gülbaş Z,Alpat SN,Erben N,Colak E

doi

10.5152/balkanmedj.2011.016

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

174-8

issue

2

eissn

2146-3123

issn

2146-3131

pii

bmj-29-2-177

journal_volume

29

pub_type

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