title: Prognostic Value and Daily Trend of Interleukin-6, Neutrophil CD64 Expression, C-Reactive Protein and Lipopolysaccharide-Binding Protein in Critically Ill Patients: Reliable Predictors of Outcome or Not?
abstract: BACKGROUND
  Severe sepsis and/or trauma complicated by multiple organ dysfunction syndrome are the leading causes of death in critically ill patients. The aim of this prospective single-centre study was to assess the prognostic value and daily trend of interleukin-6 (IL-6), neutrophil CD64 expression, C-reactive protein (CRP) and lipopolysaccharide-binding protein (LBP) regarding outcome in critically ill patients with severe trauma and/or severe sepsis. Outcome measure was hospital mortality.
  
  
  METHODS
  One hundred and two critically ill patients admitted to the intensive care unit of a tertiary university hospital were enrolled in this prospective study. Blood samples were collected on admission (day 1), days 2 and 3.
  
  
  RESULTS
  CD64 index was 1.6-fold higher on day 1 and 1.78-fold higher on day 2 in non-survivors (p<0.05). The area under the curve (AUC) for the CD64 index on day 1 for outcome was 0.727. At a cut-off level of 2.80 sensitivity was 75% and specificity was 65%. Patients with CD64 index level on day 1 higher than 2.80 had 2.4-fold higher probability of dying. Odds ratio is 2.40; 95% CI 0.60-9.67.
  
  
  CONCLUSIONS
  CD64 index on day 1 is a fairly good predictor of outcome. AUCs for IL-6, CRP and LBP were < 0.55, suggesting these biomarkers failed to predict outcome.
authors.affiliation: Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia.
authors.forename: Dragan
authors.initials: D
authors.lastname: Djordjevic
authors.affiliation: Institute of Medical Biochemistry, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia.
authors.forename: Janko
authors.initials: J
authors.lastname: Pejovic
authors.affiliation: Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia.
authors.forename: Maja
authors.initials: M
authors.lastname: Surbatovic
authors.affiliation: Faculty of Medical Sciences, University of Kragujevac, Serbia; Clinical Center Kragujevac, Serbia.
authors.forename: Jasna
authors.initials: J
authors.lastname: Jevdjic
authors.affiliation: Sector of Preventive Medicine, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia.
authors.forename: Sonja
authors.initials: S
authors.lastname: Radakovic
authors.affiliation: Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia.
authors.forename: Milic
authors.initials: M
authors.lastname: Veljovic
authors.affiliation: Sector for pharmacy, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia.
authors.forename: Aneta
authors.initials: A
authors.lastname: Peric
authors.affiliation: Institute of Medical Biochemistry, Military Medical Academy, Belgrade, Serbia.
authors.forename: Tamara
authors.initials: T
authors.lastname: Andjelic
authors.affiliation: School of Medicine, University of Belgrade, Serbia; Clinic for Burns, Plastic and Reconstructive Surgery, Belgrade, Serbia.
authors.forename: Nada
authors.initials: N
authors.lastname: Popovic
keywords: biomarkers; critical care; leukocytes; outcome; prognosis