Reddy Vaishnavi, Wante Mahendra, Nirhale Dakshayani S, Puvvada Pragna, Gaudani Romi H
Department of General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Oct 6;16(10):e70965. doi: 10.7759/cureus.70965. eCollection 2024 Oct.
Background Sepsis is a medical emergency and necessitates immediate diagnosis and treatment to prevent the progression to severe sepsis, septic shock, and potentially mortality. Aim This study aims to study the diagnostic significance of conventional and new markers, interleukin-10 (IL-10), in predicting the severity of sepsis. Methodology A prospective observational study was conducted in the department of surgery in a tertiary care hospital in Pune, India. The study included 100 patients diagnosed with a quick Sequential Organ Failure Assessment (qSOFA) score of ≥2. Serum C-reactive protein (CRP), procalcitonin (PCT), and interleukin-10 (IL-10) levels were measured. Receiver operating characteristic (ROC) curves were plotted to assess the diagnostic performance of these biomarkers. Results The mean serum CRP level on day 7 was significantly higher than the baseline, day 1, and day 3 groups (p=0.0001). On analysis by repeated measure, the ANOVA test revealed that the mean CRP levels on day 7 were significantly higher. The mean PCT levels on day 7, day 3, and day 1 groups were significantly lower than those on day 1, day 2, and day 2, respectively (p=0.0001). The mean p-value of 3.3 g/L CRP was significantly lower on day 1 than that on day 3. IL-10 levels showed a significant upward trend, rising from 5.21 pg/mL at baseline to 7.57 pg/mL by day 7, with a p-value of <0.0001. Our cohort population showed elevated IL-10 values on the day of admission in a total of 15 patients. In our study, we observed that 11 patients with elevated IL-10 levels progressed toward multiple organ dysfunction syndrome (MODS) and four mortalities. IL-10 is a crucial marker for identifying patients with worsening surgical sepsis. Conclusion IL-10, CRP, and PCT have potential as prognostic markers in assessing and predicting disease severity. The dynamic changes in these biomarkers correlate strongly with clinical outcomes, suggesting their role in guiding treatment decisions.
脓毒症是一种医疗急症，需要立即诊断和治疗，以防止进展为严重脓毒症、感染性休克，并可能导致死亡。目的：本研究旨在探讨传统标志物和新标志物白细胞介素-10（IL-10）在预测脓毒症严重程度方面的诊断意义。方法：在印度浦那一家三级护理医院的外科进行了一项前瞻性观察研究。该研究纳入了100例快速序贯器官衰竭评估（qSOFA）评分≥2的患者。检测血清C反应蛋白（CRP）、降钙素原（PCT）和白细胞介素-10（IL-10）水平。绘制受试者工作特征（ROC）曲线以评估这些生物标志物的诊断性能。结果：第7天的平均血清CRP水平显著高于基线、第1天和第3天的组（p=0.0001）。通过重复测量分析，方差分析显示第7天的平均CRP水平显著更高。第7天、第3天和第1天组的平均PCT水平分别显著低于第1天、第2天和第2天的组（p=0.0001）。第1天CRP为3.3 g/L时的平均p值显著低于第3天。IL-10水平呈显著上升趋势，从基线时的5.21 pg/mL上升至第7天时的7.57 pg/mL，p值<0.0001。我们的队列人群中共有15例患者在入院当天IL-10值升高。在我们的研究中，我们观察到11例IL-10水平升高的患者进展为多器官功能障碍综合征（MODS），4例死亡。IL-10是识别手术脓毒症病情恶化患者的关键标志物。结论：IL-10、CRP和PCT在评估和预测疾病严重程度方面具有作为预后标志物的潜力。这些生物标志物的动态变化与临床结果密切相关，表明它们在指导治疗决策中的作用。
