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Journal of critical care · Feb 2018
Revisiting the prognostic value of monocyte chemotactic protein 1 and interleukin-6 in the sepsis-3 era.
- Max Barre, Michael Behnes, Sonja Hamed, Dominic Pauly, Dominic Lepiorz, Siegfried Lang, Ibrahim Akin, Martin Borggrefe, Thomas Bertsch, and Ursula Hoffmann.
- From the First Department of Medicine (M.Ba., M.Be., S.H., D.P., D.L., S.L., I.A., M.Bo., U.H.), University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
- J Crit Care. 2018 Feb 1; 43: 21-28.
BackgroundMonocyte Chemotactic Protein 1 (MCP1) and latest sepsis-3 criteria are poorly represented within studies evaluating biomarkers in sepsis. Therefore, this study evaluates the prognostic value of MCP-1 compared to interleukin-6 (IL-6) in patients with sepsis and septic shock according to sepsis-3 criteria.Methods136 patients with sepsis or septic shock were included within 24h of intensive care unit (ICU) admission. MCP-1, IL-6, procalcitonin (PCT), C-reactive protein (CRP) and white blood cells (WBC) were measured on days 1, 3 and 8. All-cause mortality was followed up at 30days and 6months.ResultsBoth MCP-1 and IL-6 levels revealed valuable prognostic discrimination of 30-day and 6-months all-cause mortality on day 1 and 3 (MCP-1: range of AUCs 0.62-0.65, p<0.039; IL-6: range of AUCs 0.65-0.70, p<0.021) compared to PCT, CRP, SOFA and APACHE II score. MCP-1 levels within the 4th quartile revealed the highest mortality at 30days and 6months compared to patients with lower levels (range of hazard ratio (HR)=2.1-3.3, p<0.041). The prognostic value of MCP-1 sustained in multivariate regression models and was comparable to that of IL-6.ConclusionBoth MCP-1 and IL-6 revealed prognostic value for short- and mid-term all-cause mortality in patients with sepsis and septic shock according to latest sepsis-3 definitions.Published by Elsevier Inc.
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