IL-8对急诊科老年败血症患者死亡风险的预测价值

IF 3.7 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Cytokine Pub Date : 2024-10-04 DOI:10.1016/j.cyto.2024.156774

Xiangqun Zhang, Junyu Wang , Shubin Guo

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引用次数: 0

摘要

背景：败血症严重影响发病率和死亡率，尤其是老年人。尽管进行了广泛的研究，但败血症的早期识别和预后预测仍具有挑战性。IL-8是由单核细胞和内皮细胞等炎症细胞产生的一种趋化因子，已显示出预测败血症患者死亡率的潜力，但其在老年败血症中的作用仍有待探索：本研究旨在探讨白细胞介素-8（IL-8）对老年脓毒症患者死亡风险的预测能力。入院1小时内采集血清样本，评估血清IL-8、白细胞（WBC）、降钙素原（PCT）、C反应蛋白（CRP）和乳酸（LAC）水平。记录了序贯器官衰竭评分（SOFA）和急性生理与慢性健康评估 II（APACHE II）。通过逻辑回归分析，确定了确诊为败血症的老年患者 28 天内死亡率的独立预测因素。此外，还评估了这些因素预测该患者群 28 天内死亡率的能力：结果：SOFA 评分、APACHE II 评分、LAC 和 IL-8 都是老年脓毒症患者 28 天内死亡率的重要独立预测因素（P 结论：SOFA 评分、APACHE II 评分、LAC 和 IL-8 都是老年脓毒症患者 28 天内死亡率的重要独立预测因素：IL-8 LAC、APACHE II 和 SOFA 可被视为老年脓毒症患者死亡率的独立预测因素。与单独使用任何一项指标相比，IL-8 和 SOFA 的组合具有更强的预测能力。

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Predictive value of IL-8 for mortality risk in elderly sepsis patients of emergency department

Background

Sepsis significantly impacts morbidity and mortality, particularly among older adults. Despite extensive research, early recognition and prognosis prediction of sepsis remain challenging. IL-8, a chemokine produced by inflammatory cells like monocytes and endothelial cells, has shown potential in predicting mortality in sepsis patients, though its role in elderly sepsis remains unexplored.

Objectives

The present study aimed to explore the predictive ability of interleukin-8 (IL-8) for mortality risk in elderly septic patients.

Methods

220 elderly sepsis patients were included in the present study. Serum samples were obtained within 1 h of admission to assess serum IL-8, white blood cell (WBC), procalcitonin (PCT), C-reactive protein (CRP), and lactic acid (LAC) levels. The Sequential Organ Failure Score (SOFA) and Acute Physiological and Chronic Health Assessment II (APACHE II) were recorded. Logistic regression analysis was employed to identify independent predictors of mortality within 28 days for elderly patients diagnosed with sepsis. Further, the capacity of these factors to predict 28-day mortality within this patient cohort was evaluated.

Results

SOFA score, APACHE II score, LAC, and IL-8 were all significant independent predictors for 28-day mortality in elderly sepsis patients (P < 0.05). The AUC of the ROC curve for IL-8 was calculated to be 0.701, indicating a moderately predictive performance. In comparison, the AUC for LAC was marginally higher at 0.708. Nevertheless, the results of the statistical analysis revealed no significant difference in the predictive value between IL-8 and LAC. Moreover, the present findings indicate that the combined assessment of IL-8 and SOFA score demonstrated superior predictive value for mortality compared to using IL-8 alone.

Conclusions

IL-8 LAC, APACHE II, and SOFA can be considered independent predictors factors for mortality of elderly sepsis patients. Utilizing the combination of IL-8 and SOFA demonstrates a heightened predictive capability compared to using any single index alone.

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来源期刊

Cytokine 医学-免疫学

CiteScore

7.60

自引率

2.60%

发文量

262

审稿时长

48 days

期刊介绍： The journal Cytokine has an open access mirror journal Cytokine: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. * Devoted exclusively to the study of the molecular biology, genetics, biochemistry, immunology, genome-wide association studies, pathobiology, diagnostic and clinical applications of all known interleukins, hematopoietic factors, growth factors, cytotoxins, interferons, new cytokines, and chemokines, Cytokine provides comprehensive coverage of cytokines and their mechanisms of actions, 12 times a year by publishing original high quality refereed scientific papers from prominent investigators in both the academic and industrial sectors. We will publish 3 major types of manuscripts: 1) Original manuscripts describing research results. 2) Basic and clinical reviews describing cytokine actions and regulation. 3) Short commentaries/perspectives on recently published aspects of cytokines, pathogenesis and clinical results.