title: Prognostic value of interleukin 6, procalcitonin, and C-reactive protein levels in intensive care unit patients during first increase of fever.
abstract: To investigate the prognostic value of interleukin 6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) in critically ill patients during the first increase of fever, serum levels were measured in 38 patients admitted to intensive care unit of the Department of Medicine, Klinikum Grosshadern, University of Munich, immediately after increase of body temperature more than 38.3 degrees C. Ten healthy controls were also included for comparison. The onset of fever was accompanied by elevated circulating levels of all the 3 markers in comparison with healthy controls. However, only IL-6 levels were significantly higher (P < 0.05) in nonsurvivors (n = 21) compared with survivors. Sensitivity, specificity, positive, and negative predictive values calculated from median levels was higher for IL-6 compared with PCT and CRP. Areas under receiver characteristic operating curves revealed the highest area under the curve for IL-6 in contrast to PCT and CRP. These data suggest that IL-6 rather than PCT or CRP may be an early predictor of mortality in patients with onset of fever and identify patients, who need intensive monitoring to initiate appropriate therapy at an early stage.
authors.affiliation: Department of Clinical Chemistry, University Hospital Grosshadern, Munich, Germany. peter.fraunberger@med.uni-muenchen.de
authors.forename: Peter
authors.initials: P
authors.lastname: Fraunberger
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Ernst
authors.initials: E
authors.lastname: Holler
authors.forename: Klaus G
authors.initials: KG
authors.lastname: Parhofer
authors.forename: Dorothea
authors.initials: D
authors.lastname: Nagel
authors.forename: Autar K
authors.initials: AK
authors.lastname: Walli
authors.forename: Dietrich
authors.initials: D
authors.lastname: Seidel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D005334:Fever / Q000097:blood* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D015850:Interleukin-6; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide