Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients
Dublin Core
Title
Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients
Subject
Critically ill, Interleukin, Multiple organ dysfunction, Predictive marker, qSOFA
Description
Background: Shock and organ damage occur in critically ill patients in the emergency department because of
biological responses to invasion, and cytokines play an important role in their development. It is important to
predict early multiple organ dysfunction (MOD) because it is useful in predicting patient outcomes and selecting
treatment strategies. This study examined the accuracy of biomarkers, including interleukin (IL)-6, in predicting early
MOD in critically ill patients compared with that of quick sequential organ failure assessment (qSOFA).
Methods: This was a multicenter observational sub-study. Five universities from 2016 to 2018. Data of adult
patients with systemic inflammatory response syndrome who presented to the emergency department or were
admitted to the intensive care unit were prospectively evaluated. qSOFA score and each biomarker (IL-6, IL-8, IL-10,
tumor necrosis factor-α, C-reactive protein, and procalcitonin [PCT]) level were assessed on Days 0, 1, and 2. The
primary outcome was set as MOD on Day 2, and the area under the curve (AUC) was analyzed to evaluate qSOFA
scores and biomarker levels.
Results: Of 199 patients, 38 were excluded and 161 were included. Patients with MOD on Day 2 had significantly
higher qSOFA, SOFA, and Acute Physiology and Chronic Health Evaluation II scores and a trend toward worse
prognosis, including mortality. The AUC for qSOFA score (Day 0) that predicted MOD (Day 2) was 0.728 (95%
confidence interval [CI]: 0.651–0.794). IL-6 (Day 1) showed the highest AUC among all biomarkers (0.790 [95% CI:
0.711–852]). The combination of qSOFA (Day 0) and IL-6 (Day 1) showed improved prediction accuracy (0.842 [95%
CI: 0.771–0.893]). The combination model using qSOFA (Day 1) and IL-6 (Day 1) also showed a higher AUC (0.868
[95% CI: 0.799–0.915]). The combination model of IL-8 and PCT also showed a significant improvement in AUC.
Conclusions: The addition of IL-6, IL-8 and PCT to qSOFA scores improved the accuracy of early MOD prediction
biological responses to invasion, and cytokines play an important role in their development. It is important to
predict early multiple organ dysfunction (MOD) because it is useful in predicting patient outcomes and selecting
treatment strategies. This study examined the accuracy of biomarkers, including interleukin (IL)-6, in predicting early
MOD in critically ill patients compared with that of quick sequential organ failure assessment (qSOFA).
Methods: This was a multicenter observational sub-study. Five universities from 2016 to 2018. Data of adult
patients with systemic inflammatory response syndrome who presented to the emergency department or were
admitted to the intensive care unit were prospectively evaluated. qSOFA score and each biomarker (IL-6, IL-8, IL-10,
tumor necrosis factor-α, C-reactive protein, and procalcitonin [PCT]) level were assessed on Days 0, 1, and 2. The
primary outcome was set as MOD on Day 2, and the area under the curve (AUC) was analyzed to evaluate qSOFA
scores and biomarker levels.
Results: Of 199 patients, 38 were excluded and 161 were included. Patients with MOD on Day 2 had significantly
higher qSOFA, SOFA, and Acute Physiology and Chronic Health Evaluation II scores and a trend toward worse
prognosis, including mortality. The AUC for qSOFA score (Day 0) that predicted MOD (Day 2) was 0.728 (95%
confidence interval [CI]: 0.651–0.794). IL-6 (Day 1) showed the highest AUC among all biomarkers (0.790 [95% CI:
0.711–852]). The combination of qSOFA (Day 0) and IL-6 (Day 1) showed improved prediction accuracy (0.842 [95%
CI: 0.771–0.893]). The combination model using qSOFA (Day 1) and IL-6 (Day 1) also showed a higher AUC (0.868
[95% CI: 0.799–0.915]). The combination model of IL-8 and PCT also showed a significant improvement in AUC.
Conclusions: The addition of IL-6, IL-8 and PCT to qSOFA scores improved the accuracy of early MOD prediction
Creator
Shigeto Ishikawa, Yuto Teshima, Hiroki Otsubo, Takashi Shimazui, Taka-aki Nakada, Osamu Takasu, Kenichi Matsuda, Junichi Sasaki, Masakazu Nabeta, Takeshi Moriguchi, Takayuki Shibusawa, Toshihiko Mayumi and Shigeto Oda
Publisher
BMC Emergency Medicine
Date
(2021) 21:132
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Shigeto Ishikawa, Yuto Teshima, Hiroki Otsubo, Takashi Shimazui, Taka-aki Nakada, Osamu Takasu, Kenichi Matsuda, Junichi Sasaki, Masakazu Nabeta, Takeshi Moriguchi, Takayuki Shibusawa, Toshihiko Mayumi and Shigeto Oda, “Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/3914.