Plasma pro- and anti-inflammatory cytokine levels and outcome prediction in unselected critically ill patients
Plasma pro- and anti-inflammatory cytokine levels and outcome prediction in unselected critically ill patients
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DOI：
10.1016/j.cyto.2007.11.019
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发表时间：
2008-03-01
期刊：
影响因子：
3.8
通讯作者：
Armaganidis, Apostolos
中科院分区：
文献类型：
--
作者：
Dirriopoulou, Ioanna;Orfanos, Stylianos;Armaganidis, Apostolos
目的。确定细胞因子水平和生理评分之间的相互关系，以预测未经选择的危重患者的结果。方法。为此，我们对 127 名患者（96 名男性）进行了前瞻性调查，这些患者的平均 +/- SD 年龄为 45 +/- 20 岁，入院诊断范围广泛（内科、外科和多发性创伤患者）。危重症和器官功能障碍的严重程度分别通过急性生理学和慢性健康评估（APACHE 11）和序贯器官衰竭评估（SOFA）评分进行分级。入住 ICU 时抽取血样以确定促炎和抗炎细胞因子，包括肿瘤坏死因子 (TNF)-α、白细胞介素 (IL)-6、IL-8 和 IL-10。主要结果指标是 28 天死亡率。结果。总体而言.. 88 名患者幸存，39 名患者死亡。单变量逻辑回归分析显示，入住 ICU 时的 SOFA、APACHE 11、IL-8、IL-6 和 IL-10 与死亡率相关。对整个危重患者队列的多元逻辑回归分析显示，SOFA（OR = 1.341，p < 0.001）和IL-6（OR = 1.075，p = 0.01）构成独立的结果预测因子。接受者操作者特征曲线分析表明，SOFA、APACHE II 和 IL-6 具有最高的曲线值下面积。 IL-6 与 APACHE II (r(s) = 0.44，p < 0.0001) 和 SOFA (rs = 0.40，p < 0.0001) 评分相关。结论。在混合 ICU 患者中，入住 ICU 时的细胞因子浓度代表存在疾病严重程度评分的独立结果预测因子。 (c) 2007 Elsevier Ltd. 保留所有权利。
Purpose. To determine the inter-relation ships between cytokine levels and physiological scores in predicting outcome in unselected, critically ill patients. Methods. To this end, 127 patients (96 men), having a mean +/- SD age of 45 +/- 20 years, with a wide range in admission diagnoses (medical, surgical, and multiple trauma patients) were prospectively investigated. Severity of critical illness and organ dysfunction were graded by acute physiology and chronic health evaluation (APACHE 11) and sequential organ failure assessment (SOFA) scores, respectively. Blood samples were drawn on admission in the ICU to determine pro- and anti-inflammatory cytokines, including tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-8, and IL-10. The main outcome measure was 28-day mortality. Results. Overall.. 88 patients survived and 39 patients died. Univariate logistic regression analysis showed that SOFA, APACHE 11, IL-8, IL-6, and IL-10 on admission in the ICU were related to mortality. Multiple logistic regression analysis in the entire cohort of critically ill patients revealed that SOFA (OR = 1.341, p < 0.001) and IL-6 (OR = 1.075, p = 0.01) constituted independent outcome predictors. receiver operator characteristics curve analysis showed that SOFA, APACHE II, and IL-6 had the highest area under the Curve values. IL-6 correlated with APACHE II (r(s) = 0.44, p < 0.0001) and SOFA (rs = 0.40, p < 0.0001) scores. Conclusions. In mixed ICU patients cytokine concentrations on admission in the ICU represent independent outcome predictors in the presence of disease severity scores. (c) 2007 Elsevier Ltd. All rights reserved.