A combined ratio change of inflammatory biomarkers at 72 h could predict the severity and prognosis of sepsis from pulmonary infections

Abstract

Purpose: To determine the association of a combined ratio change of inflammatory biomarkers at 72 h after admission on sepsis severity and prognosis from pulmonary infections.

Methods: Data on adult patients diagnosed with sepsis, or septic shock were retrospectively analyzed. Patients were divided into two groups, according to their outcome of hospitalization. Blood specimens were obtained on admission (T₀) and 72 h (T₇₂) after therapy. Acute Physiology And Chronic Health Evaluation Score (APACHEII) and Sequential Organ Failure Assessment Score (SOFA) were statistically analyzed on admission. Survivors discharged from hospital were classified into different subgroups according to the change in biomarkers at T₇₂, and compared for different clinical prognosis.

Results: Our study showed that IL-6, IL-8, IL-10 and TNF-a could predict the severity of sepsis at T₀, since they showed a positive correlation with APACHEII or SOFA score. Another important finding was that survivors discharged from hospital whose ratio change with IL-10, i.e: IL-10/IL-6, IL-10/IL-8, IL-10/TNF-a ≤ 0 exhibited significantly greater 9-month overall survival. We also observed that patients with increased IL-6 after 72 h showed similar improved survival.

Conclusion: Our findings suggested that a combined ratio change of inflammatory biomarkers was an effective predictor for sepsis severity and prognosis.

Keywords: 9-Month overall survival prognosis; Cytokine; Sepsis biomarkers.