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Title: Prognostic value of cytokine concentrations (tumor necrosis factor-α, interleukin-6, and interleukin-10) and clinical parameters in severe melioidosis
Authors: Andrew J.H. Simpson
Michael D. Smith
Gerrit Jan Weverling
Yupin Suputtamongkol
Brian J. Angus
Wipada Chaowagul
Nicholas J. White
Sander J.H. Van Deventer
Jan M. Prins
Mahidol University
Sappasitthiprasong Hospital
Nuffield Department of Clinical Medicine
Academic Medical Centre, University of Amsterdam
Taunton and Somerset NHS Trust
Keywords: Medicine
Issue Date: 15-Mar-2000
Citation: Journal of Infectious Diseases. Vol.181, No.2 (2000), 621-625
Abstract: Raised serum concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, or IL-10 are associated with mortality in patients with sepsis, but it is not known whether elevated cytokine levels are independently predictive of mortality. Cytokine assays (TNF-α, IL-6, and IL-10) were performed on admission plasma samples from 172 adult Thai patients with severe melioidosis. Mortality was 31.4%. APACHE II score; septicemia; plasma lactate; TNF-α, IL-6, and IL-10 concentrations; and IL- 10/TNF-α and IL-6/IL-10 ratios were each associated with outcome (P ≤ .001 for all variables). Only the APACHE II score and either IL-6 or IL-10 concentration were independent predictors of mortality, as determined by use of multiple logistic regression (with cytokine concentrations and ratios entered separately). In a multivariate analysis, including both IL-6 and IL- 10, the IL-10 concentration was no longer predictive. Therefore, APACHE II scores and either IL-6 or IL-10 concentration may be the most reliable parameters for stratification of patients in future studies of severe gram- negative sepsis.
ISSN: 00221899
Appears in Collections:Scopus 1991-2000

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