Diagnostic and Prognostic Value of Interleukin-6 in Emergency Department Sepsis Patients

Abstract

Purpose The objective of this study was to explore the diagnostic and prognostic value of interleukin-6 (IL-6) in sepsis patients presenting to the emergency department. Patients and Methods A total of 128 patients who visited the emergency department of West Hospital of Beijing Chaoyang Hospital, affiliated to Capital Medical University, from November 2021 to February 2022 were subjected to this study. According to Sepsis-3.0 diagnostic criteria for sepsis, patients were divided into non-sepsis group (65 cases) and sepsis group (63 cases). Demographic data and clinical characteristics of the two patient groups were compared. Serum levels of biomarkers including IL-6, blood urea nitrogen (BUN), and lactic acid (Lac) were compared with Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Scale (GCS) scores. Logistic regression was used to analyze independent risk factors and Receiver Operating Characteristic Curve (ROC) method was used to analyze the Area Under the Curve (AUC) to determine the diagnostic and prognostic value of markers. Results Compared with non-sepsis patients, levels of IL-6, PCT, CRP and BUN were significantly higher in sepsis patients (10.84 (4.41–27.01): 92.22 (21.53–201.12), 0.03 (0.01–0.1):0.49 (0.08–3.1), 8.3 (0.5–31.8):39.8(10.3–98.6), 7.01 (4.90–11.74):13.03 (6.93–25.99), all p = 0.001). IL-6, BUN and mean arterial pressure (MAP) were independent risk factors for sepsis diagnosis. AUC values of IL-6, BUN, MAP and IL-6+BUN+MAP were 0.764, 0.696, 0.685, and 0.848, respectively. Lactate, age and SOFA score were independent risk factors for 28-day mortality in sepsis patients. The AUC of Lac, age, SOFA score and Lac+age+SOFA score to predict 28-day death in sepsis patients was 0.679, 0.626, 0.747, and 0.819, respectively. Conclusion IL-6 is an independent predictor of sepsis diagnosis, and the combination of blood BUN and MAP has superior diagnostic performance. Lac, age, and SOFA score could effectively predict clinical outcomes in patients with sepsis.

Basal procalcitonin, C-reactive protein, interleukin-6, and presepsin for prediction of mortality in critically ill septic patients: a systematic review and meta-analysis

“…The remaining domains were considered at moderate risk of bias, mostly due to unclear reporting of missing participants (i.e., losses at follow-up), missing information (i.e., missing biomarker information), and unclear methods of measurement (i.e., mortality measurement). Only two study providing information about PCT, IL-6 and CRP was considered at low risk of bias in all QUIPS-domains (Additional file S 5 ) [ 62 , 66 ].…”

Clinical biomarker profiles reveals gender differences and mortality factors in sepsis

“…No literature currently indicates normal IL-6 levels vary by gender; a meta-analysis showed healthy donors’ IL-6 levels ranged from 0 to 43.5 pg/ml ( 40 ). IL-6 is considered a biomarker with high diagnostic and prognostic value in sepsis ( 41 – 43 ), quickly rising to peak levels early in sepsis ( 41 ). This matches our findings of significantly increased IL-6 expression in female patients; male patients showed no significant change, possibly due to insufficient data.…”

Биологические Маркеры Сепсиса

“…Измерение уровня PCT, лактата и эндотоксина у детей с тяжелой пневмонией, осложненной сепсисом, предложено использовать для диагностики и оценки прогноза заболевания [53]. Уровень лактата, возраст и оценка по шкале SOFA эффективно прогнозируют клинические исходы у пациентов с сепсисом [54].…”

“…У взрослых пациентов IL6 считается независимым предиктором диагноза «сепсис» [54], а также высокочувствительным и специфичным диагностическим маркером [33]. Одновременная регистрация уровней IL6 и лактата в динамике может быть независимым предиктором летального исхода у пациентов с сепсисом.…”