title: Predictive Value of IL-8 for Sepsis and Severe Infections After Burn Injury: A Clinical Study.
abstract: The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring postburn inflammation is of paramount importance but, so far, there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As interleukin 8 (IL-8) is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict postburn sepsis, infections, and mortality. Plasma cytokines, acute-phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days after injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure [MOF], and mortality) were recorded. A cutoff level for IL-8 was determined using receiver operating characteristic analysis. Statistical significance is set at P < 0.05. Receiver operating characteristic analysis identified a cutoff level of 234 pg/mL for IL-8 for survival. Patients were grouped according to their average IL-8 levels relative to this cutoff and stratified into high (H) (n = 133) and low (L) (n = 335) groups. In the L group, regression analysis revealed a significant predictive value of IL-8 to percent of total body surface area burned and incidence of MOF (P < 0.001). In the H group, IL-8 levels were able to predict sepsis (P < 0.002). In the H group, elevated IL-8 was associated with increased inflammatory and acute-phase responses compared with the L group (P < 0.05). High levels of IL-8 correlated with increased MOF, sepsis, and mortality. These data suggest that serum levels of IL-8 may be a valid biomarker for monitoring sepsis, infections, and mortality in burn patients.
authors.affiliation: *Shriners Hospitals for Children, and †Department of Surgery, Shriners Hospitals for Children; ‡Institute for Translational Sciences and Sealy Center for Molecular Medicine, University of Texas Medical Branch; and §Department of Pathology, Shriners Hospitals for Children, Galveston; and ∥Department of Surgery, University of Texas Southwestern, Dallas, Texas; and ¶Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Department of Surgery, Division of Plastic Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Kraft
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.forename: Celeste C
authors.initials: CC
authors.lastname: Finnerty
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cox
authors.forename: Juquan
authors.initials: J
authors.lastname: Song
authors.forename: Marc G
authors.initials: MG
authors.lastname: Jeschke
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002056:Burns / Q000097:blood* / Q000150:complications* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007239:Infections / Q000097:blood* / Q000209:etiology* / Q000401:mortality; D018836:Inflammation Mediators / Q000097:blood; D016209:Interleukin-8 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008297:Male; D009102:Multiple Organ Failure / Q000097:blood / Q000209:etiology / Q000401:mortality; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000209:etiology* / Q000401:mortality
chemical_list: D015415:Biomarkers; C508606:CXCL8 protein, human; D018836:Inflammation Mediators; D016209:Interleukin-8