Diagnostic and Prognostic Value of Interleukin-6 in Emergency Department Sepsis Patients

Abstract

Baozhong Yu, Maolin Chen, Ye Zhang, Yudan Cao, Jun Yang, Bing Wei, Junyu Wang Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, & Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Clinical Center for Medicine in Acute Infection, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Bing Wei; Junyu Wang, Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, & Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Clinical Center for Medicine in Acute Infection, Capital Medical University, Beijing, 100020, People’s Republic of China, Email [email protected]; [email protected]: The objective of this study was to explore the diagnostic and prognostic value of interleukin-6 (IL-6) in sepsis patients presenting to the emergency department.Patients and Methods: A total of 128 patients who visited the emergency department of West Hospital of Beijing Chaoyang Hospital, affiliated to Capital Medical University, from November 2021 to February 2022 were subjected to this study. According to Sepsis-3.0 diagnostic criteria for sepsis, patients were divided into non-sepsis group (65 cases) and sepsis group (63 cases). Demographic data and clinical characteristics of the two patient groups were compared. Serum levels of biomarkers including IL-6, blood urea nitrogen (BUN), and lactic acid (Lac) were compared with Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Scale (GCS) scores. Logistic regression was used to analyze independent risk factors and Receiver Operating Characteristic Curve (ROC) method was used to analyze the Area Under the Curve (AUC) to determine the diagnostic and prognostic value of markers.Results: Compared with non-sepsis patients, levels of IL-6, PCT, CRP and BUN were significantly higher in sepsis patients (10.84 (4.41– 27.01): 92.22 (21.53– 201.12), 0.03 (0.01– 0.1):0.49 (0.08– 3.1), 8.3 (0.5– 31.8):39.8(10.3– 98.6), 7.01 (4.90– 11.74):13.03 (6.93– 25.99), all p = 0.001). IL-6, BUN and mean arterial pressure (MAP) were independent risk factors for sepsis diagnosis. AUC values of IL-6, BUN, MAP and IL-6+BUN+MAP were 0.764, 0.696, 0.685, and 0.848, respectively. Lactate, age and SOFA score were independent risk factors for 28-day mortality in sepsis patients. The AUC of Lac, age, SOFA score and Lac+age+SOFA score to predict 28-day death in sepsis patients was 0.679, 0.626, 0.747, and 0.819, respectively.Conclusion: IL-6 is an independent predictor of sepsis diagnosis, and the combination of blood BUN and MAP has superior diagnostic performance. Lac, age, and SOFA score could effectively predict clinical outcomes in patients with sepsis.Keywords: interleukin-6, emergency department, Lac, sepsis, SOFA score, mortality

Keywords

• interleukin-6
• emergency department
• lac
• sepsis
• sofa score
• mortality;