Evaluation of serum TNF-alpha, IL-10, leptin, CRP levels as prognostic markers in patients with sepsis and septic shock

Abstract number: P1070

Cesur S., Sengul A., Kurtoglu Y., Arslan Ozel S., Kalpakci Y., Bilgeturk A., Kinikli S., Erdem H., Biyikli Z., Eyigun C., Bulut C., Aslan T.

Aim: The aim of this study was to determine the diagnostic value of serum TNF-alpha, IL-10, leptin, CRP levels in differentiating sepsis from septic shock and the prognostic value of these evels in predicting mortality or outcome in patients with sepsis and septic shock.

Material and Methods: Forty-sixth patients with sepsis (32 of sepsis and 14 of septic shock) and 50 healthy subjects were inluded in the study. Serum TNF-alpha, IL-10, leptin, CRP levels were compared between patients with sepsis and septic shock and healthy subjects and the prognostic value of these markers in predicting mortality were determined. For this aim, before treatment(1st day) and during the 3rd and 5th days of treatment serum TNF-alpha, IL-10, leptin, CRP levels were compared between patients with sepsis and septic shock and with those of healthy controls. For statistical evaluation, Mann-Whitney and Fisher's Exact tests were used.

Results: Serum CRP levels were significantly lower in patients with septic shock than sepsis before treatment. On the 3rd day of treatment, there was no difference in any parameter other than CRP levels. While serum CRP levels were found to be low in patients with sepsis on 3rd day, they were increased in patients with septic shock. On the 5th day of treatment, no difference was found in any parameter between patients with sepsis and septic shock.

In the patient group (both sepsis and septic shock), in the comparison between patients who survive and those who die, no difference was found in the parameters before treatment except for IL-10 levels, serum IL-10 levels being higher in the patients who died. On the 3rd day of treatment, serum TNF-alpha and CRP levels were different between surviving and dying patients. Serum TNF-alpha and CRP levels were higher in dying patients than those in surviving patients. On the 5th day of treatment, merely serum TNF-alpha levels were different between dying and surviving patients, values being higher in dying patients.

Conclusion: When the diagnostic value and prognostic values of these markers were evaluated, CRP levels were useful in discriminating between sepsis and septic shock before treatment and on the 3rd day of treatment, whilst IL-10 and TNF-alpha levels were useful in predicting mortality in patients with sepsis before treatment and on the 5th day of treatment respectively.

This project was supported by Scientific and Technical Research Council of the Turkish Republic with project number of SBAG-2841(104S358).