IL-6 predicts organ dysfunction and mortality in patients with multiple injuries.
BACKGROUND
Although therapeutic concepts of patients with major trauma have improved during recent years, organ dysfunction still remains a frequent complication during clinical course in intensive care units. It has previously been shown that cytokines are upregulated under stress conditions such as trauma or sepsis. However, it is still debatable if cytokines are adequate parameters to describe the current state of trauma patients. To elucidate the relevance of cytokines, we investigated if cytokines predict development of multiple organ dysfunction syndrome (MODS) or outcome.


METHODS
A total of 143 patients with an injury severity score >or= 16, between 16 and 65 years, admitted to the Hannover Medical School Level 1 Trauma Center between January 1997 and December 2001 were prospectively included in this study. Marshall Score for MODS was calculated for at least 14 days and plasma levels of TNF-alpha, IL-1beta, IL-6, IL-8 and IL-10 were measured. To determine the association between cytokine levels and development of MODS the Spearman rank correlation coefficient was calculated and logistic regression and analysis were performed.


CONCLUSIONS
Patients with MODS had increased plasma levels of IL-6, IL-8 and IL-10. IL-6 predicted development of MODS with an overall accuracy of 84.7% (specificity: 98.3%, sensitivity: 16.7%). The threshold value for development of MODS was 761.7 pg/ml and 2176.0 pg/ml for mortality during the in patient time.


CONCLUSIONS
We conclude that plasma IL-6 levels predict mortality and that they are a useful tool to identify patients who are at risk for development of MODS.
Trauma Department, Hannover Medical School, Hannover, Germany. michaelfrink@web.de
Michael
M
Frink
Martijn
M
van Griensven
Philipp
P
Kobbe
Thomas
T
Brin
Christian
C
Zeckey
Bernhard
B
Vaske
Christian
C
Krettek
Frank
F
Hildebrand
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology*; D009104:Multiple Trauma / Q000097:blood* / Q000401:mortality* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D055815:Young Adult
D015850:Interleukin-6