title: Predictive value of procalcitonin and interleukin 6 in critically ill patients with suspected sepsis.
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.
  
  
  METHODS
  Prospective, cohort study in two university hospital intensive care units.
  
  
  METHODS
  61 critically ill patients with suspected sepsis.
  
  
  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).
authors.affiliation: Department of Surgery, Division of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, P.O. Box 340, 00029/HUS, Helsinki, Finland. ville.pettila@hus.fi
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
authors.forename: Marja
authors.initials: M
authors.lastname: Hynninen
authors.forename: Olli
authors.initials: O
authors.lastname: Takkunen
authors.forename: Pentti
authors.initials: P
authors.lastname: Kuusela
authors.forename: Matti
authors.initials: M
authors.lastname: Valtonen
mesh_terms: D018806:APACHE; D000328:Adult; D000990:Antithrombin III / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D016638:Critical Illness; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005387:Finland; D017052:Hospital Mortality; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*
chemical_list: C000606589:CALCA protein, human; D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; D011498:Protein Precursors; C036309:fibrin fragment D; D000990:Antithrombin III; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide