title: Correlation of interleukin-6, serum lactate, and C-reactive protein to inflammation, complication, and outcome during the surgical course of patients with acute abdomen.
abstract: In the present scenario, doctors have to rely on radiological methods for diagnosis of acute abdomen in addition to their clinical skill. The use of serum markers for assessing the outcome of such patients is still debatable. Our aim was to evaluate whether the combined use of serum lactate, interleukin (IL)-6, and C-reactive protein (CRP) is able to simultaneously establish both the septic status and the prognosis of acute abdomen. Ninety-nine patients undergoing surgery for acute abdomen were taken up for the study. The patients were divided into 4 groups based on the level of sepsis. Serum lactate, IL-6, and CRP were determined in the serum of all the subjects. It was found that serum lactate determination, using the cutoff value < 3.9 mM, had a high sensitivity (100%) and specificity (83%) in differentiating patients with severe sepsis from those with sepsis. IL-6 came next with a sensitivity of 87% and a specificity of 81%. The AUC for serum lactate (0.922), IL-6 (0.912), and CRP (0.719) in differentiating between patients with severe sepsis and those with sepsis also proves the superiority of serum lactate and IL-6. The combined use of serum lactate and IL-6 would allow us to simultaneously establish the prognosis of patients with acute abdomen (r(2) = 0.368, P = 0.008). The combined use of serum lactate and IL-6 is useful in simultaneously establishing both the severity of sepsis and, hence, the prognosis of acute abdomen.
authors.affiliation: Department of Surgery, Coimbatore Medical College, Coimbatore, Ganapathy, India. pravashu2624@gmail.com
authors.forename: Praveen
authors.initials: P
authors.lastname: Ravishankaran
authors.forename: Ashwini M
authors.initials: AM
authors.lastname: Shah
authors.forename: Ravindra
authors.initials: R
authors.lastname: Bhat
mesh_terms: D000006:Abdomen, Acute / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000175:diagnosis*; D015850:Interleukin-6 / Q000097:blood*; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood / Q000175:diagnosis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015850:Interleukin-6; D019344:Lactic Acid; D002097:C-Reactive Protein