Andrew J.H. SimpsonMichael D. SmithGerrit Jan WeverlingYupin SuputtamongkolBrian J. AngusWipada ChaowagulNicholas J. WhiteSander J.H. Van DeventerJan M. PrinsMahidol UniversitySappasitthiprasong HospitalNuffield Department of Clinical MedicineAcademic Medical Centre, University of AmsterdamTaunton and Somerset NHS Trust2018-09-072018-09-072000-03-15Journal of Infectious Diseases. Vol.181, No.2 (2000), 621-625002218992-s2.0-0034048834https://repository.li.mahidol.ac.th/handle/20.500.14594/26262Raised 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.Mahidol UniversityMedicineArticleSCOPUS10.1086/315271