Prognostic Value of Cytokine Concentrations (Tumor Necrosis Factor±a, Interleukin-6, and Interleukin-10) and Clinical Parameters

Raised serum concentrations of tumor necrosis factor (TNF)±a, interleukin (IL)±1b, IL-6, or IL-10 are associated with mortality in patients with sepsis, but it is not known whether elevated cytokine levels are independently predictive of mortality. Cytokine assays (TNF-a, IL-6, and IL-10) were performed on admission plasma samples from 172 adult Thai patients with severe melioidosis. Mortality was 31.4%. APACHE II score; septicemia; plasma lactate; TNF-a, IL-6, and IL-10 concentrations; and IL-10/TNF-a and IL-6/IL-10 ratios were each associated with outcome ( for all variables). Only the APACHE II score and eitherP <.001 IL-6 or IL-10 concentration were independent predictors of mortality, as determined by use of multiple logistic regression (with cytokine concentrations and ratios entered separately)