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

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-...

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Published in:BMC infectious diseases Vol. 19; no. 1; pp. 968 - 11
Main Authors: Song, Juhyun, Park, Dae Won, Moon, Sungwoo, Cho, Han-Jin, Park, Jong Hak, Seok, Hyeri, Choi, Won Seok
Format: Journal Article
Language:English
Published: London BioMed Central 12.11.2019
BioMed Central Ltd
BMC
Subjects:
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
Sepsis
Septic shock
Emergency department
Pentraxin 3
Procalcitonin
Interleukin-6
ISSN:1471-2334, 1471-2334
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Summary: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.
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ISSN:1471-2334
1471-2334
DOI:10.1186/s12879-019-4618-7