血清白细胞介素 6 在预测成人败血症患者菌血症中的诊断潜力:一项前瞻性观察研究

IF 1.5 Q3 CRITICAL CARE MEDICINE Indian Journal of Critical Care Medicine Pub Date : 2024-07-01 DOI:10.5005/jp-journals-10071-24754
Penna Rv Reddy, Mounika Cherukuri, Vandana K Eshwara, Chandrashekar Udyavara Kudru, Rv Krishnananda Prabhu
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引用次数: 0

摘要

背景:本研究旨在评估血清白细胞介素-6(IL-6)作为预测菌血症的诊断标志物的潜力,并确定其与败血症患者的严重程度和预后的关系:开展了一项前瞻性观察研究,研究对象为2019年1月至2020年4月期间入住重症监护室的118名疑似败血症患者:在分析的 108 名患者中,60 人(55.6%)为菌血症患者,48 人(44.4%)为非菌血症患者。在 60 名菌血症患者中,13 人(21.6%)患有败血症,47 人(78.3%)患有脓毒性休克。在预测菌血症时,IL-6的曲线下面积(AUC)为0.512 [95% CI, 0.400-0.623]。在区分败血症和脓毒性休克时,IL-6的曲线下面积为0.724 [95% CI, 0.625-0.823]。IL-6 预测菌血症的敏感性和特异性分别为 66% 和 67%(P < 0.001)。多变量分析显示,C反应蛋白(CRP)(p = 0.04)和 APACHE II 评分(p = 0.025)是预测菌血症的重要指标,而乳酸(p = 0.04)和 APACHE II 评分(p < 0.001)则是预测脓毒症严重程度的重要指标。降钙素原 PCT(p = 0.024)、APACHE II(p = 0.003)和 SOFA(p = 0.002)评分升高的患者死亡率明显更高:结论:与IL-6相比,C反应蛋白和APACHE II评分、乳酸和APACHE II评分以及PCT、SOFA和APACHE II评分在预测菌血症、脓毒症严重程度和临床结局方面分别有更好的表现:Reddy PRV, Cherukuri M, Eshwara VK, Kudru CU, Prabhu RVK.血清白细胞介素-6在预测成人败血症患者菌血症中的诊断潜力:前瞻性观察研究》。Indian J Crit Care Med 2024;28(7):637-644.
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Diagnostic Potential of Serum Interleukin-6 in Predicting Bacteremia in Adult Patients with Sepsis: A Prospective Observational Study.

Background: This study aimed to assess the potential of serum interleukin-6 (IL-6) as a diagnostic marker in predicting bacteremia and to determine its association with severity and outcome among sepsis patients.

Materials and methods: A prospective observational study was conducted, comprising a cohort of 118 patients admitted to the ICU with suspected sepsis from January 2019 to April 2020.

Results: Among the 108 patients analyzed, 60 (55.6%) were bacteremic and 48 (44.4%) were nonbacteremic. Of 60 patients with bacteremia, 13 (21.6%) had sepsis and 47 (78.3%) had septic shock. In predicting bacteremia, the area under the curve (AUC) for IL-6 was 0.512 [95% CI, 0.400-0.623]. The AUC for IL-6 in differentiating sepsis from septic shock was 0.724 [95% CI, 0.625-0.823]. The sensitivity and specificity for predicting bacteremia for IL-6 were 66% and 67%, respectively (p < 0.001). Multivariate analysis revealed that C-reactive protein (CRP) (p = 0.04) and APACHE II score (p = 0.025) were significant predictors of bacteremia, whereas lactate (p = 0.04), and APACHE II score (p < 0.001) were significant predictors of sepsis severity. Patients with elevated levels of procalcitonin PCT (p = 0.024), APACHE II (p = 0.003), and SOFA (p = 0.002) scores had significantly higher mortality rates.

Conclusion: C-reactive protein and APACHE II score, lactate and APACHE II score, and PCT, SOFA, and APACHE II scores performed better in predicting bacteremia, sepsis severity, and clinical outcome, respectively compared with IL-6.

How to cite this article: Reddy PRV, Cherukuri M, Eshwara VK, Kudru CU, Prabhu RVK. Diagnostic Potential of Serum Interleukin-6 in Predicting Bacteremia in Adult Patients with Sepsis: A Prospective Observational Study. Indian J Crit Care Med 2024;28(7):637-644.

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来源期刊
CiteScore
3.50
自引率
10.00%
发文量
299
期刊介绍: Indian Journal of Critical Care Medicine (ISSN 0972-5229) is specialty periodical published under the auspices of Indian Society of Critical Care Medicine. Journal encourages research, education and dissemination of knowledge in the fields of critical and emergency medicine.
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