Cytokine profiles in sepsis have limited relevance for stratifying patients in the emergency department: a prospective observational study

Autor: Laurent Arnaud, Yonathan Freund, Guy Gorochov, Christophe Parizot, Virginie Lvovschi, Martin Larsen, Gaëlle Juillien, Mohammed Bouberima, Pierre Hausfater, Pascale Ghillani-Dalbin, Bruno Riou
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Bacterial Diseases
Male
Anatomy and Physiology
Critical Care and Emergency Medicine
Multivariate analysis
medicine.medical_treatment
lcsh:Medicine
Biochemistry
Immune Physiology
Prospective Studies
Prospective cohort study
lcsh:Science
Immune Response
Aged
80 and over
Principal Component Analysis
Univariate analysis
Multidisciplinary
Bacterial Infections
Middle Aged
Shock
Septic
Clinical Laboratory Sciences
Systemic Inflammatory Response Syndrome
Infectious Diseases
Cytokine
Cytokines
Medicine
Female
France
Emergency Service
Hospital
Research Article
Biotechnology
Adult
medicine.medical_specialty
Fever
Immunology
Immunopathology
Microbiology
Immunomodulation
Sepsis
Young Adult
Diagnostic Medicine
Internal medicine
medicine
Humans
Intensive care medicine
Biology
Aged
Septic shock
business.industry
lcsh:R
Emergency department
medicine.disease
Systemic inflammatory response syndrome
Clinical Immunology
lcsh:Q
business
Zdroj: PLoS ONE, Vol 6, Iss 12, p e28870 (2011)
PLoS ONE
ISSN: 1932-6203
Popis: Introduction Morbidity, mortality and social cost of sepsis are high. Previous studies have suggested that individual cytokines levels could be used as sepsis markers. Therefore, we assessed whether the multiplex technology could identify useful cytokine profiles in Emergency Department (ED) patients. Methods ED patients were included in a single tertiary-care center prospective study. Eligible patients were >18 years and met at least one of the following criteria: fever, suspected systemic infection, ≥2 systemic inflammatory response syndrome (SIRS) criteria, hypotension or shock. Multiplex cytokine measurements were performed on serum samples collected at inclusion. Associations between cytokine levels and sepsis were assessed using univariate and multivariate logistic regressions, principal component analysis (PCA) and agglomerative hierarchical clustering (AHC). Results Among the 126 patients (71 men, 55 women; median age: 54 years [19–96 years]) included, 102 had SIRS (81%), 55 (44%) had severe sepsis and 10 (8%) had septic shock. Univariate analysis revealed weak associations between cytokine levels and sepsis. Multivariate analysis revealed independent association between sIL-2R (p = 0.01) and severe sepsis, as well as between sIL-2R (p = 0.04), IL-1β (p = 0.046), IL-8 (p = 0.02) and septic shock. However, neither PCA nor AHC distinguished profiles characteristic of sepsis. Conclusions Previous non-multiparametric studies might have reached inappropriate conclusions. Indeed, well-defined clinical conditions do not translate into particular cytokine profiles. Additional and larger trials are now required to validate the limited interest of expensive multiplex cytokine profiling for staging septic patients.
Databáze: OpenAIRE
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