Lim Kai Yang, Shukeri Wan Fadzlina Wan Muhd, Hassan Wan Mohd Nazaruddin Wan, Mat-Nor Mohd Basri, Hanafi Muhammad Hafiz
Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
Department of Anaesthesiology and Intensive Care, School of Medical Sciences, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.
Indian J Crit Care Med. 2022 Oct;26(10):1126-1130. doi: 10.5005/jp-journals-10071-24324.
The association between interleukin-6 (IL-6) and serum albumin (ALB) with mortality in critically ill elderly patients, either as stand-alone biomarkers or in combination, has been scarcely reported. We, therefore, aimed to investigate the prognostic value of the IL-6-to-albumin ratio in this special population.
This was a cross-sectional study conducted in the mixed intensive care unit (ICU) of two university-affiliated hospitals in Malaysia. Consecutive elderly patients (aged above or equal to 60 years) admitted to the ICU, who underwent simultaneous measurement of plasma IL-6 and serum ALB, were recruited. The prognostic value of the IL-6-to-albumin ratio was assessed by analysis of the receiver-operating characteristic (ROC) curve.
A total of 112 critically ill elderly patients were recruited. The outcome of all-cause ICU mortality was 22.3%. The calculated IL-6-to-albumin ratio was significantly higher in the non-survivors compared to the survivors {14.1 [interquartile range (IQR), 6.5-26.7] vs 2.5 [(IQR, 0.6-9.2) pg/mL, <0.001]}. The area under the curve (AUC) of IL-6-to-albumin ratio for discrimination of ICU mortality was 0.766 [95% confidence interval (CI), 0.667-0.865, <0.001] which was slightly higher than that of IL-6 and albumin alone. The ideal cut-off value of the IL-6-to-albumin ratio was above 5.7 with a sensitivity of 80.0% and specificity of 64.4%. After adjusting for severity of illness, the IL-6-to-albumin ratio remained as an independent predictor of ICU mortality with an adjusted odd ratio of 0.975 (95% CI, 0.952-0.999, = 0.039).
The IL-6-to-albumin ratio offers a slight improvement in mortality prediction than either of its constituent individual biomarkers and as such, it may be a potential tool to aid in the prognostication of critically ill elderly patients although this requires further validation in a larger prospective study.
Lim KY, Shukeri WFWM, Hassan WMNW, Mat-Nor MB, Hanafi MH. The Combined Use of Interleukin-6 with Serum Albumin for Mortality Prediction in Critically Ill Elderly Patients: The Interleukin-6-to-albumin Ratio. Indian J Crit Care Med 2022;26(10):1126-1130.
白细胞介素-6（IL-6）和血清白蛋白（ALB）作为单独的生物标志物或联合使用时，与危重症老年患者死亡率之间的关联鲜有报道。因此，我们旨在研究IL-6与白蛋白比值在这一特殊人群中的预后价值。
这是一项在马来西亚两所大学附属医院的混合重症监护病房（ICU）进行的横断面研究。纳入在ICU住院的连续老年患者（年龄大于或等于60岁），这些患者同时进行了血浆IL-6和血清ALB的检测。通过分析受试者工作特征（ROC）曲线评估IL-6与白蛋白比值的预后价值。
共纳入112例危重症老年患者。全因ICU死亡率为22.3%。与存活患者相比，非存活患者计算得出的IL-6与白蛋白比值显著更高{14.1[四分位数间距（IQR），6.5 - 26.7] vs 2.5[（IQR，0.6 - 9.2）pg/mL，<0.001]}。用于区分ICU死亡率的IL-6与白蛋白比值的曲线下面积（AUC）为0.766[95%置信区间（CI），0.667 - 0.865，<0.001]，略高于单独的IL-6和白蛋白。IL-6与白蛋白比值的理想截断值高于5.7，敏感性为80.0%，特异性为64.4%。在调整疾病严重程度后，IL-6与白蛋白比值仍然是ICU死亡率的独立预测指标，调整后的比值比为0.975（95%CI，0.952 - 0.999，P = 0.039）。
与单独的IL-6和白蛋白这两种生物标志物相比，IL-6与白蛋白比值在死亡率预测方面略有改善。因此它可能是辅助预测危重症老年患者预后的潜在工具，尽管这需要在更大规模的前瞻性研究中进一步验证。
Lim KY, Shukeri WFWM, Hassan WMNW, Mat-Nor MB, Hanafi MH. 白细胞介素-6与血清白蛋白联合用于危重症老年患者死亡率预测：白细胞介素-6与白蛋白比值。《印度重症医学杂志》2022；26(10):1126 - 1130。
