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  • Title: Predictive value of procalcitonin and interleukin 6 in critically ill patients with suspected sepsis.
    Author: Pettilä V, Hynninen M, Takkunen O, Kuusela P, Valtonen M.
    Journal: Intensive Care Med; 2002 Sep; 28(9):1220-5. PubMed ID: 12209268.
    Abstract:
    OBJECTIVE: To evaluate the performance of procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein, leukocyte count, D-dimer, and antithrombin III at onset of septic episode and 24 h later in prediction of hospital mortality in critically ill patients with suspected sepsis. DESIGN AND SETTING: Prospective, cohort study in two university hospital intensive care units. PATIENTS: 61 critically ill patients with suspected sepsis. MEASUREMENTS AND RESULTS: The outcome measure was hospital mortality. Hospital survivors ( n=41) and nonsurvivors ( n=20) differed statistically significantly on day 1 (admission) in PCT, IL-6, SOFA score, and APACHE II score, and 24 h later in PCT, IL-6, and D-dimer values. AT III, CRP, and leukocyte count did not differ. The areas under receiver operating curves showed reasonable discriminative power (>0.75) in predicting hospital mortality only for day 2 IL-6 (0.799) and day 2 PCT (0.777) values which were comparable to that of APACHE II (0.786), and which remained the only independent predictor of mortality. CONCLUSIONS: Admission and day 2 IL-6, and day 2 PCT, and day 2 D-dimer values differed significantly between hospital survivors and nonsurvivors among critically ill patients with suspected sepsis. However, in prediction of hospital mortality, only the discriminative power of day 2 PCT and IL-6 values, and APACHE II was reasonable as judged by AUC analysis (>0.75).
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