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. 2019 Nov 12;19(1):968.
doi: 10.1186/s12879-019-4618-7.

Diagnostic and prognostic value of interleukin-6, pentraxin 3, and procalcitonin levels among sepsis and septic shock patients: a prospective controlled study according to the Sepsis-3 definitions

Juhyun Song  1 , Dae Won Park  2 , Sungwoo Moon  1 , Han-Jin Cho  1 , Jong Hak Park  1 , Hyeri Seok  3 , Won Seok Choi  3
Affiliations

Diagnostic and prognostic value of interleukin-6, pentraxin 3, and procalcitonin levels among sepsis and septic shock patients: a prospective controlled study according to the Sepsis-3 definitions

Juhyun Song et al. BMC Infect Dis. .

Abstract

Background: This study investigated the clinical value of interleukin-6 (IL-6), pentraxin 3 (PTX3), and procalcitonin (PCT) in patients with sepsis and septic shock diagnosed according to the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

Methods: Serum levels of IL-6, PTX3, and PCT were measured in 142 enrolled subjects (51 with sepsis, 46 with septic shock, and 45 as controls). Follow-up IL-6 and PTX3 levels were measured in patients with initial septic shock within 24 h of hospital discharge. Optimal cut-off values were determined for sepsis and septic shock, and prognostic values were evaluated.

Results: Serum IL-6 levels could discriminate sepsis (area under the curve [AUC], 0.83-0.94, P < 0.001; cut-off value, 52.60 pg/mL, 80.4% sensitivity, 88.9% specificity) from controls and could distinguish septic shock (AUC, 0.71-0.89; cut-off value, 348.92 pg/mL, 76.1% sensitivity, 78.4% specificity) from sepsis. Twenty-eight-day mortality was significantly higher in the group with high IL-6 (≥ 348.92 pg/mL) than in the group with low IL-6 (< 348.92 pg/mL) (P = 0.008). IL-6 was an independent risk factor for 28-day mortality among overall patients (hazard ratio, 1.0004; 95% confidence interval, 1.0003-1.0005; p = 0.024). In septic shock patients, both the initial and follow-up PTX3 levels were consistently significantly higher in patients who died than in those who recovered (initial p = 0.004; follow-up P < 0.001).

Conclusions: The diagnostic and prognostic value of IL-6 was superior to those of PTX3 and PCT for sepsis and septic shock.

Keywords: Emergency department; Interleukin-6; Pentraxin 3; Procalcitonin; Sepsis; Septic shock.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow Chart of the Study Population. F/U, follow-up
Fig. 2
Fig. 2
Interleukin-6, pentraxin 3, procalcitonin, and lactate levels in sepsis and septic shock patients. Patients were diagnosed in the emergency department according to Sepsis-3 definitions. CRP, C-reactive protein
Fig. 3
Fig. 3
Receiver operating characteristic curves for distinguishing sepsis or septic shock. Sepsis (a) and septic shock (b) are variously discriminated by interleukin-6, pentraxin 3, lactate, and procalcitonin levels measured in the emergency department
Fig. 4
Fig. 4
Kaplan-Meier curve of 28-day mortality in patients with sepsis and septic shock. The curve is stratified by the optimal cut-off value of pentraxin 3 (a) and interleukin-6 (b) to predict septic shock (28-day mortality by pentraxin 3: 14.6% vs. 45.9%; 28-day mortality by interleukin-6: 5.1% vs. 49.1%)
Fig. 5
Fig. 5
Error bars of initial and follow-up levels of interleukin-6 and pentraxin 3. Error bars are shown for the levels of interleukin-6 (a) and pentraxin 3 (b) in septic shock patients who died or recovered during admission. Initial and follow-up levels were taken within 6 h of clinical diagnosis and 24 h of discharge, respectively
See this image and copyright information in PMC

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