Association between cytokine response, the LRINEC score and outcome in patients with necrotising soft tissue infection: a multicentre, prospective study.

2.50
Hdl Handle:
http://hdl.handle.net/10033/620929
Title:
Association between cytokine response, the LRINEC score and outcome in patients with necrotising soft tissue infection: a multicentre, prospective study.
Authors:
Hansen, Marco Bo; Rasmussen, Lars Simon; Svensson, Mattias; Chakrakodi, Bhavya; Bruun, Trond; Madsen, Martin Bruun; Perner, Anders; Garred, Peter; Hyldegaard, Ole; Norrby-Teglund, Anna
Abstract:
Early assessment of necrotising soft tissue infection (NSTI) is challenging. Analysis of inflammatory markers could provide important information about disease severity and guide decision making. For this purpose, we investigated the association between cytokine levels and the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC)-score, disease severity and mortality in NSTI patients. In 159 patients, plasma was analysed for IL-1β, IL-6, IL-10 and TNF-α upon admission. The severity of NSTI was assessed by SAPS, SOFA score, septic shock, microbial aetiology, renal replacement therapy and amputation. We found no significant difference in cytokine levels according to a LRINEC- score above or below 6 (IL-1β: 3.0 vs. 1.3; IL-6: 607 vs. 289; IL-10: 38.4 vs. 38.8; TNF-α: 15.1 vs. 7.8 pg/mL, P > 0.05). Patients with β-haemolytic streptococcal infection had higher level of particularly IL-6. There was no difference in mortality between patients with a LRINEC-score above or below 6. In the adjusted analysis assessing 30-day mortality, the association was strongest for IL-1β (OR 3.86 [95% CI, 1.43-10.40], P = 0.008) and IL-10 (4.80 [1.67-13.78], P = 0.004). In conclusion, we found no significant association between the LRINEC-score and cytokine levels on admission. IL-6 was consistently associated with disease severity, whereas IL-1β had the strongest association with 30-day mortality.
Affiliation:
Helmholtz Centre for infection research, Inhoffenstr. 7., 38124 Braunschweig, Germany.
Citation:
Association between cytokine response, the LRINEC score and outcome in patients with necrotising soft tissue infection: a multicentre, prospective study. 2017, 7:42179 Sci Rep
Journal:
Scientific reports
Issue Date:
8-Feb-2017
URI:
http://hdl.handle.net/10033/620929
DOI:
10.1038/srep42179
PubMed ID:
28176831
Type:
Article
Language:
en
ISSN:
2045-2322
Appears in Collections:
publications of the research group microbial interactions and processes (MINP)

Full metadata record

DC FieldValue Language
dc.contributor.authorHansen, Marco Boen
dc.contributor.authorRasmussen, Lars Simonen
dc.contributor.authorSvensson, Mattiasen
dc.contributor.authorChakrakodi, Bhavyaen
dc.contributor.authorBruun, Tronden
dc.contributor.authorMadsen, Martin Bruunen
dc.contributor.authorPerner, Andersen
dc.contributor.authorGarred, Peteren
dc.contributor.authorHyldegaard, Oleen
dc.contributor.authorNorrby-Teglund, Annaen
dc.date.accessioned2017-05-31T13:57:35Z-
dc.date.available2017-05-31T13:57:35Z-
dc.date.issued2017-02-08-
dc.identifier.citationAssociation between cytokine response, the LRINEC score and outcome in patients with necrotising soft tissue infection: a multicentre, prospective study. 2017, 7:42179 Sci Repen
dc.identifier.issn2045-2322-
dc.identifier.pmid28176831-
dc.identifier.doi10.1038/srep42179-
dc.identifier.urihttp://hdl.handle.net/10033/620929-
dc.description.abstractEarly assessment of necrotising soft tissue infection (NSTI) is challenging. Analysis of inflammatory markers could provide important information about disease severity and guide decision making. For this purpose, we investigated the association between cytokine levels and the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC)-score, disease severity and mortality in NSTI patients. In 159 patients, plasma was analysed for IL-1β, IL-6, IL-10 and TNF-α upon admission. The severity of NSTI was assessed by SAPS, SOFA score, septic shock, microbial aetiology, renal replacement therapy and amputation. We found no significant difference in cytokine levels according to a LRINEC- score above or below 6 (IL-1β: 3.0 vs. 1.3; IL-6: 607 vs. 289; IL-10: 38.4 vs. 38.8; TNF-α: 15.1 vs. 7.8 pg/mL, P > 0.05). Patients with β-haemolytic streptococcal infection had higher level of particularly IL-6. There was no difference in mortality between patients with a LRINEC-score above or below 6. In the adjusted analysis assessing 30-day mortality, the association was strongest for IL-1β (OR 3.86 [95% CI, 1.43-10.40], P = 0.008) and IL-10 (4.80 [1.67-13.78], P = 0.004). In conclusion, we found no significant association between the LRINEC-score and cytokine levels on admission. IL-6 was consistently associated with disease severity, whereas IL-1β had the strongest association with 30-day mortality.en
dc.language.isoenen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/*
dc.titleAssociation between cytokine response, the LRINEC score and outcome in patients with necrotising soft tissue infection: a multicentre, prospective study.en
dc.typeArticleen
dc.contributor.departmentHelmholtz Centre for infection research, Inhoffenstr. 7., 38124 Braunschweig, Germany.en
dc.identifier.journalScientific reportsen

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