Are IL-6, IL-10 and PCT plasma concentrations reliable for outcome prediction in severe sepsis? A comparison with APACHE III and SAPS II.

OBJECTIVE

Prospective examination whether changes in interleukin (IL)-6, IL-10 or procalcitonin (PCT) concentrations correlate with poor outcome in patients with severe sepsis in comparison with APACHE III or SAPS II.

METHODS

33 patients who fulfilled the criteria for severe sepsis have been included in the study. Blood samples were collected for cytokine and PCT determinations. The Acute Physiology, Age and Chronic Health Evaluation (APACHE) III score and the Simplified Acute Physiology Score (SAPS) II were calculated for 3 consecutive days.

RESULTS

14 out of 33 patients died of multiple organ failure. The areas under the ROC-curves for APACHE III and SAPS II indicated a poor discrimination between survivors and non-survivors. Plasma PCT and IL-10 concentrations were higher in non-survivors than in survivors. IL-6 levels showed no differences between groups. The multivariate analysis of the APACHE III, SAPS II, IL-10 and PCT data showed a significant relationship between APACHE III, PCT plasma levels and outcome.

CONCLUSIONS

The data suggest that non-surviving patients have higher PCT and IL-10 values. Only APACHE III score and PCT plasma levels correlated with a poor outcome. Therefore, routine measurements of plasma PCT concentrations might be helpful to improve the mortality risk prediction in patients with severe sepsis.