Interleukin 6, galectin 3, growth differentiation factor 15, and soluble ST2 for mortality prediction in critically ill patients.
The aim of this study was to compare the prognostic value of interleukin 6 (IL-6), galectin 3, growth differentiation factor 15 (GDF-15), and soluble ST2 (sST2) in an unselected cohort of critically ill patients.



During a study period of 1 year, we recruited 530 consecutive patients admitted to a medical intensive care unit of a tertiary care hospital. We examined a combination of inflammatory, renal, and cardiac biomarkers for the prediction of 90-day all-cause mortality.



During follow-up, 118 patients died (22%). In univariate analyses, increased IL-6, galectin 3, GDF-15, and sST2 plasma concentrations at baseline were strong prognostic markers. However, in the multivariate models, only IL-6 and sST2 remained independent biomarkers adding additional prognostic information to the routinely used Simplified Acute Physiology Score (SAPS) II. Using a simple multimarker approach, patients with increased SAPS II, IL-6, and sST2 (ie, SAPS II >35, IL-6 >32.3pg/mL, and sST2 >103ng/mL) had the poorest outcome.



In this heterogeneous group of critically ill patients, only SAPS II, IL-6, and sST2 remained independent and additive prognostic markers for 90-day all-cause mortality. A combination of the SAPS II with the 2 complementary biomarkers might provide a valuable tool for risk stratification of critically ill patients.
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria. Electronic address: benjamin.dieplinger@bs-lab.at.
Benjamin
B
Dieplinger
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria.
Margot
M
Egger
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria.
Isabella
I
Leitner
Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria.
Fritz
F
Firlinger
Institute for Applied System Sciences and Statistics, University of Linz, Linz, Austria.
Werner
W
Poelz
Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria.
Kurt
K
Lenz
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria.
Meinhard
M
Haltmayer
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria.
Thomas
T
Mueller
D000368:Aged; D001317:Austria; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D003422:Critical Care; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D037502:Galectin 3 / Q000097:blood; D055436:Growth Differentiation Factor 15 / Q000097:blood; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D000072179:Interleukin-1 Receptor-Like 1 Protein / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis
D015415:Biomarkers; D037502:Galectin 3; D055436:Growth Differentiation Factor 15; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D015850:Interleukin-6
Interleukin 1 receptor family; Interleukin 33; Natriuretic peptide; Procalcitonin; Transforming growth factor super family; Troponin