title: Prognostic value of blood interleukin-6 in the prediction of functional outcome after stroke: a systematic review and meta-analysis.
abstract: We aimed to quantify the association of blood interleukin-6 (IL-6) concentrations with poor outcome after stroke and its added predictive value over clinical information. Meta-analysis of 24 studies confirmed this association with a weighted mean difference of 3.443 (1.592-5.294) pg/mL, despite high heterogeneity and publication bias. Individual participant data including 4112 stroke patients showed standardized IL-6 levels in the 4th quartile were independently associated with poor outcome (OR=2.346 (1.814-3.033), p<0.0001). However, the additional predictive value of IL-6 was moderate (IDI=1.5%, NRI=5.35%). Overall these results indicate an unlikely translation of IL-6 into clinical practice for this purpose.
authors.affiliation: Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain; Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Bustamante
authors.affiliation: Department of Neurology, Clinical Neurosciences Research Laboratory, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Tomás
authors.initials: T
authors.lastname: Sobrino
authors.affiliation: Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.
authors.forename: Dolors
authors.initials: D
authors.lastname: Giralt
authors.affiliation: Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: García-Berrocoso
authors.affiliation: Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.
authors.forename: Victor
authors.initials: V
authors.lastname: Llombart
authors.affiliation: Neurology Department, Hospital de Cruces, Bilbao, Spain.
authors.forename: Iratxe
authors.initials: I
authors.lastname: Ugarriza
authors.affiliation: Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Espadaler
authors.affiliation: Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Noelia
authors.initials: N
authors.lastname: Rodríguez
authors.affiliation: Centre for Clinical Brain Sciences, University of Edinburgh, UK.
authors.forename: Cathie
authors.initials: C
authors.lastname: Sudlow
authors.affiliation: Department of Neurology, Hospital Universitario Dr. Josep Trueta of Girona, Biomedical Research Institute of Girona, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Castellanos
authors.affiliation: Stroke and Vascular Research Centre, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, UK.
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Smith
authors.affiliation: Department of Neurology, Clinical Neurosciences Research Laboratory, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodríguez-Yánez
authors.affiliation: Department of Neurology, Haukeland University Hospital, Norway.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Waje-Andreassen
authors.affiliation: Sagol Neuroscience Center, Chaim Sheba Medical Center and Tel Aviv University, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Tanne
authors.affiliation: University of Tokushima Graduate School, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Oto
authors.affiliation: Stroke Managed Clinical Network, NHS Lanarkshire, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Barber
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Worthmann
authors.affiliation: Department of Neurology, Martin-Luther-University Halle-Wittenberg, Germany.
authors.forename: Katja E
authors.initials: KE
authors.lastname: Wartenberg
authors.affiliation: Department of Neurology and Neurological Surgery, University of Washington School of Medicine, Seattle, WA, United States.
authors.forename: Kyra J
authors.initials: KJ
authors.lastname: Becker
authors.affiliation: Department of Biochemistry, Dr. D. Y. Patil Medical College, Mumbai, India.
authors.forename: Baidarbhi
authors.initials: B
authors.lastname: Chakraborty
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
authors.forename: Seung-Hun
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Centre for Clinical Brain Sciences, University of Edinburgh, UK.
authors.forename: William N
authors.initials: WN
authors.lastname: Whiteley
authors.affiliation: Department of Neurology, Clinical Neurosciences Research Laboratory, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Castillo
authors.affiliation: Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain; Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain. Electronic address: 31862jmv@comb.cat.
authors.forename: Joan
authors.initials: J
authors.lastname: Montaner
mesh_terms: D015415:Biomarkers / Q000097:blood; D006801:Humans; D015850:Interleukin-6 / Q000097:blood / Q000276:immunology*; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function / Q000276:immunology*; D020521:Stroke / Q000175:diagnosis / Q000276:immunology* / Q000378:metabolism
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6
keywords: Individual participant data analysis; Interleukin-6; Meta-analysis; Outcome; Post-stroke infection; Stroke