title: Interleukin-8 predicts 60-day mortality in premature infants with necrotizing enterocolitis.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the predictiveness of circulating interleukin (IL)-8 for 60-day mortality in premature infants with necrotizing enterocolitis (NEC).
  
  
  BACKGROUND
  NEC affects up to 5% of premature infants and remains a leading cause of mortality among neonates.
  
  
  METHODS
  A total of 113 infants with surgically (n=50) or medically (n=63) treated NEC were retrospectively analyzed. Laboratory parameters including serum IL-8 were assessed at the diagnosis of NEC and during the preoperative workup.
  
  
  RESULTS
  The 60-day mortality was 19% (22/113), 10% (6/63) in medical and 33% (16/50) in surgical NEC. IL-8 levels significantly correlated with 60-day mortality (odds ratio: 1.38; CI 1.14-1.67; p=0.001). Median IL-8 levels at diagnosis were significantly higher in neonates who were later treated surgically (median=2625 pg/ml; range: 27-7500) compared with those treated medically (median=156 pg/ml; range: 5-7500; p<0.001). The AUC to discriminate between medical and surgical NEC was 0.82 (CI, 0.74-0.90), and an exploratory IL-8 cutoff point could be established at 1783 pg/ml (sensitivity of 90.5%; specificity of 59.2%).
  
  
  CONCLUSIONS
  Our findings that serum IL-8 (i) correlates directly with 60-day mortality and (ii) differs significantly between medically and surgically treated infants may change the process of therapeutic decision making in NEC.
authors.affiliation: Department of Pediatric Surgery, Medical University of Vienna, Vienna, Austria. Electronic address: thomas.benkoe@meduniwien.ac.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Benkoe
authors.affiliation: Department of Pediatric Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Carlos
authors.initials: C
authors.lastname: Reck
authors.affiliation: Department of Pediatric Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Mario
authors.initials: M
authors.lastname: Pones
authors.affiliation: Department of Pediatrics, Division of Neonatology, Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria.
authors.forename: Manfred
authors.initials: M
authors.lastname: Weninger
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Gleiss
authors.affiliation: Department of General Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Anton
authors.initials: A
authors.lastname: Stift
authors.affiliation: Department of Pediatric Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Winfried
authors.initials: W
authors.lastname: Rebhandl
mesh_terms: D015415:Biomarkers; D004200:Diseases in Twins / Q000097:blood / Q000401:mortality / Q000601:surgery / Q000628:therapy; D020345:Enterocolitis, Necrotizing / Q000097:blood* / Q000401:mortality; D005260:Female; D005865:Gestational Age; D017052:Hospital Mortality; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D016209:Interleukin-8 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008297:Male; D016017:Odds Ratio; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; C508606:CXCL8 protein, human; D016209:Interleukin-8; D014662:Vasoconstrictor Agents
keywords: IL-8; Interleukin-8; Mortality; NEC; Necrotizing enterocolitis; Neonates; Outcome; Surgery