Journal des biomarqueurs moléculaires et du diagnostic

The Utility of Pyrogenic Cytokine (IL-1β, TNF-α and IL-6) Detection In Risk Stratification of Critically lll Febrile Patients in Emergency Department

Abstract

Francesco Travaglino, Gerardo Salerno, Veronica Russo, Mariateresa Corsetti, Rosaria D’Urso, Patrizia Cardelli, Maria Rosaria Torrisi, Vincenzo Visco and Salvatore Di Somma

Objective: Aim of our study was to evaluate the prognostic value of pyrogenic cytokines (IL-1β, TNF-α and IL-6) detection associated with Mid regional pro-Amedullin (MR-proADM) and the APACHE II score in febrile patients admitted to the Emergency Department (ED).

Material: 64 patients in the Emergency Room (ER) during a period of 12 months with body temperature >37°C were recruited for this study. In order to compare MR-proADM and cytokine values, a control group of 40 healthy volunteers was enrolled. For each subject, the APACHE II score was calculated.

Result: MR-proADM and cytokines were significantly higher in patients compared to controls (p<0.0001). When APACHE II score was correlated to MR-proADM and cytokines and grouped into quartile, it showed a significant increase in TNF-α and IL-6 levels (p<0.0001). A significant stepwise increase in MR-proADM in accordance with IL-6 quartile levels was observed (p<0.0001). The receiver operating characteristic (ROC) curve showed the ability of those combined biomarkers to predict hospitalization.

Conclusion: The combined use of MR-proADM and cytokines can help the febrile patient’s management in the ED, predicting a subsequent hospitalization of such individuals.