Profile of Serum Inflammatory Biomarkers in Children with Peritonitis and their Role in Predicting the Severity and Outcome.

Abstract

Aims and objectives: The aim of this study was to determine whether the levels of serum inflammatory markers (C-reactive protein [CRP], interleukin-6 [IL-6], calprotectin, and N terminal pro-B-type natriuretic peptide [NT-proBNP]) predict the severity and outcome in children with peritonitis. The primary objective was to evaluate the profile of these serum inflammatory biomarkers in children with peritonitis. The secondary objectives were to correlate the level of these biomarkers with pediatric sequential organ failure assessment (pSOFA) severity score at admission and predict the outcome (mortality).

Methods: In this prospective observational study, the level of above serum inflammatory biomarkers in children with peritonitis was measured at the time of admission. The disease severity was assessed using pSOFA score and the association of these biomarkers with the outcomes was studied.

Results: A total of 80 children with peritonitis (M: F:: 9:7, mean age: 6.22 ± 3.7 years) were included. The median values of serum CRP, IL-6, calprotectin, and NT-proBNP were 196.88 mg/L (interquartile range [IQR]: 124.37, 285.6), 6.74 pg/ml (IQR: 1.87, 12.54), 46750 μg/L (IQR: 17937.5, 84075), and 365.2 ng/L (IQR: 170, 1034), respectively. Serum CRP and NT-proBNP correlated with pSOFA score. The pSOFA score >4 and serum NT-proBNP were significant in predicting mortality in children with peritonitis (p < 0.001).

Conclusion: In children with peritonitis, serum levels of inflammatory biomarkers, i.e. CRP, calprotectin, and NT-proBNP were found to be raised, whereas IL-6 was not raised. The pSOFA score >4 predicted mortality. The serum levels of NT-proBNP were significantly raised in nonsurvivors in children with peritonitis, therefore, can be used as a predictor of severity and mortality in children with peritonitis.