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ORIGINAL ARTICLE
Year : 2014  |  Volume : 9  |  Issue : 3  |  Page : 162-167

Interleukin-6 and procalcitonin as biomarkers in mortality prediction of hospitalized patients with community acquired pneumonia


1 Institute for Pulmonary Diseases of Vojvodina, Clinical Trials Unit, Faculty of Medicine, University of Novi Sad, Serbia
2 Institute of Oncology, Faculty of Medicine, University of Novi Sad, Serbia

Correspondence Address:
Bojan Zaric
Institute for Pulmonary Diseases of Vojvodina, Clinic for Pulmonary Oncology, Department for Invasive Diagnostics, Clinical Trials Unit, Faculty of Medicine, University of Novi Sad, Serbia. Put Doktora Goldmana 4, 21204 Sremska Kamenica
Serbia
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DOI: 10.4103/1817-1737.134072

PMID: 24987476

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Introduction: Community acquired pneumonia (CAP) may present as life-threatening infection with uncertain progression and outcome of treatment. Primary aim of the trial was determination of the cut-off value of serum interleukin-6 (IL-6) and procalcitonin (PCT) above which, 30-day mortality in hospitalized patients with CAP, could be predicted with high sensitivity and specificity. We investigated correlation between serum levels of IL-6 and PCT at admission and available scoring systems of CAP (pneumonia severity index-PSI, modified early warning score-MEWS and (Confusion, Urea nitrogen, respiratory rate, Blood pressure, ≥65 years of age-CURB65). Methods: This was prospective, non-randomized trial which included 101 patients with diagnosed CAP. PSI, MEWS and CURB65 were assessed on first day of hospitalization. IL-6 and PCT were also sampled on the first day of hospitalization. Results: Based on ROC curve analysis (AUC ± SE = 0.934 ± 0.035; 95%CI(0.864-1.0); P = 0.000) hospitalized CAP patients with elevated IL-6 level have 93.4% higher risk level for lethal outcome. Cut-off value of 20.2 pg/ml IL-6 shows sensitivity of 84% and specificity of 87% in mortality prediction. ROC curve analysis confirmed significant role of procalcitonin as a mortality predictor in CAP patients (AUC ± SE = 0.667 ± 0.062; 95%CI(0.546-0.789); P = 0.012). Patients with elevated PCT level have 66.7% higher risk level for lethal outcome. As a predictor of mortality at the cut-off value of 2.56 ng/ml PCT shows sensitivity of 76% and specificity of 61.8%. Conclusions: Both IL-6 and PCI are significant for prediction of 30-day mortality in hospitalized patients with CAP. Serum levels of IL6 correlate with major CAP scoring systems.


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