title: The diagnostic ability of procalcitonin and interleukin-6 to differentiate infectious from noninfectious systemic inflammatory response syndrome and to predict mortality.
abstract: The purpose of the study was to quantify the ability of procalcitonin (PCT) and interleukin-6 (IL-6) to differentiate noninfectious systemic inflammatory response syndrome (SIRS) and sepsis and to predict hospital mortality.
  
  
  
  We recruited consecutively adult patients with SIRS admitted to an intensive care unit. They were divided into sepsis and noninfectious SIRS based on clinical assessment with or without positive cultures. Concentrations of PCT and IL-6 were measured daily over the first 3 days.
  
  
  
  A total of 239 patients were recruited, 164 (68.6%) had sepsis, and 68 (28.5%) died in hospital. The PCT levels were higher in sepsis compared with noninfectious SIRS throughout the 3-day period (P < .0001). On admission, PCT concentration was diagnostic of sepsis (area under the curve of 0.63 [0.55-0.71]), and IL-6 was predictive of mortality, (area under the curve of 0.70 [0.62-0.78]). Peak IL-6 concentration improved the risk assessment of Sequential Organ Failure Assessment (SOFA) score for prediction of mortality among those who went on to die by an average of 5% and who did not die by 2%
  
  
  
  Procalcitonin measured on intensive care unit admission was diagnostic of sepsis, and IL-6 was predictive of mortality. Addition of IL-6 concentration to SOFA score improved risk assessment for prediction of mortality. Future studies should include clinical indices, for example, SOFA score, for prognostic evaluation of biomarkers.
authors: Department of Anaesthesiolgy and Intensive Care, Kulliyyah of Medicine, Jalan Hospital Campus, International Islamic University Malaysia, 25100 Kuantan, Pahang, Malaysia. Electronic address: basri.matnor@gmail.com.
authors: Mohd Basri
authors: MB
authors: Mat-Nor
authors: Department of Anaesthesiolgy and Intensive Care, Kulliyyah of Medicine, Jalan Hospital Campus, International Islamic University Malaysia, 25100 Kuantan, Pahang, Malaysia.
authors: Azrina
authors: A
authors: Md Ralib
authors: Department of Basic Medical Sciences, Kulliyyah of Medicine, Jalan Hospital Campus, International Islamic University Malaysia, 25100 Kuantan, Pahang, Malaysia.
authors: Nor Zamzila
authors: NZ
authors: Abdulah
authors: Department of Medicine, University of Otago, 2 Riccarton Avenue, PO Box 4345, Christchurch, New Zealand.
authors: John W
authors: JW
authors: Pickering
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002116:Calcitonin / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis* / Q000401:mortality
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D002116:Calcitonin
keywords: Diagnosis; Interleukin-6; Mortality; Procalcitonin; Sepsis