학술논문

Performance of interleukin-27 as a sepsis diagnostic biomarker in critically ill adults
Document Type
article
Source
Journal of Critical Care. 29(5)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Infectious Diseases
Sepsis
Clinical Research
Lung
Hematology
2.1 Biological and endogenous factors
Aetiology
Detection
screening and diagnosis
4.1 Discovery and preclinical testing of markers and technologies
Inflammatory and immune system
Infection
Age Factors
Aged
Aged
80 and over
Area Under Curve
Biomarkers
Calcitonin
Calcitonin Gene-Related Peptide
Critical Illness
Decision Trees
Diagnosis
Differential
Female
Humans
Interleukin-27
Male
Middle Aged
Protein Precursors
ROC Curve
Respiratory Tract Infections
Systemic Inflammatory Response Syndrome
Interleukin 27
Procalcitonin
Diagnosis
Nursing
Emergency & Critical Care Medicine
Clinical sciences
Allied health and rehabilitation science
Language
Abstract
PurposeWe recently identified interleukin-27 (IL-27) as a sepsis diagnostic biomarker in children. Here we assess IL-27 as a sepsis diagnostic biomarker in critically ill adults with systemic inflammatory response syndrome and sepsis.MethodsIL-27 and procalcitonin (PCT) were measured from plasma samples in three groups: no sepsis (n = 78), pulmonary source of sepsis (n = 66), and non-pulmonary source of sepsis (n = 43). Receiver operating characteristic curves and classification and regression tree methodology were used to evaluate biomarker performance.ResultsIL-27 did not discriminate effectively between sepsis and sterile systemic inflammatory response syndrome in unselected patients. The highest area under the curve (AUC) was 0.70 (95% C.I. 0.60 - 0.80) for IL-27 in subjects with a non-pulmonary source of sepsis. A decision tree incorporating IL-27, PCT, and age had an AUC of 0.79 (0.71-0.87) in subjects with a non-pulmonary source of sepsis. Compared to children with sepsis, adults with sepsis express less IL-27.ConclusionsIL-27 performed overall poorly in this cohort as a sepsis diagnostic biomarker. Combining IL-27, PCT, and age reasonably estimated the risk of sepsis in subjects with a non-pulmonary source of sepsis. IL-27 may be a more reliable sepsis diagnostic biomarker in children than in adults.