Elsevier

Cytokine

Volume 81, May 2016, Pages 94-100
Cytokine

Comparison and relationship of thyroid hormones, IL-6, IL-10 and albumin as mortality predictors in case-mix critically ill patients

https://doi.org/10.1016/j.cyto.2016.03.004Get rights and content
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open access

Highlights

  • IL-6 and IL-10 are related with Low FT3 and hypoalbuminemia.

  • Thyroid hormones assessed at EICU admission might not have any predictive value for mortality prediction.

  • IL-6 and IL-10 with albumin could be more reliable to assessing disease’s severity and mortality prediction.

  • When combining cytokines and albumin with APACHE II score could improve the mortality prediction in critically ill patients.

Abstract

Objective

To compare the ability of thyroid hormones, IL-6, IL-10, and albumin to predict mortality, and to assess their relationship in case-mix acute critically ill patients.

Methods

APACHE II scores and serum thyroid hormones (FT3, FT4, and TSH), IL-6, IL-10, and albumin were obtained at EICU admission for 79 cases of mix acute critically ill patients without previous history of thyroid disease. Patients were followed for 28 days with patient’s death as the primary outcome. All mean values were compared, correlations assessed with Pearson’ test, and mortality prediction assessed by multivariate logistic regression and ROC.

Results

Non survivors were older, with higher APACHE II score (p = 0.000), IL-6 (p < 0.05), IL-10 (p = 0.000) levels, and lower albumin (p = 0.000) levels compared to survivors at 28 days. IL-6 and IL-10 had significant negative correlation with albumin (p = 0.001) and FT3 (p  0.05) respectively, while low albumin had a direct correlation with FT3 (p < 0.05). In the mortality prediction assessment, IL-10, albumin and APACHE II were independent morality predictors and showed to have a good (0.70–0.79) AUC-ROC (p < 0.05). Despite that the entire cohort showed low FT3 serum levels (p = 0.000), there was not statistical difference between survivors and non-survivors; neither showed any significance as mortality predictor.

Conclusions

IL-6 and IL-10 are correlated with Low FT3 and hypoalbuminemia. Thyroid hormones assessed at EICU admission did not have any predictive value in our study. And finally, high levels of IL-6 and IL-10 in conjunction with albumin could improve our ability to evaluate disease’s severity and predict mortality in the critically ill patients. When use in combination with APACHE II scores, our model showed improved mortality prediction.

Abbreviations

AUC
area under the curve
APACHE II
Acute Physiology and Chronic Health Evaluation II
EICU
emergency intensive care unit
ICU
intensive care unit
IFN
interferon
IL
interleukin
LT3
Low T3 syndrome
NTIS
nonthyroidal illness syndrome
FT3
Free Triiodothyronine
ROS
reactive oxygen species
ROC curve
receiver operating characteristic curve
rT3
reverse Triiodothyronine
T3
Triiodothyronine
T4
Thyroxine
TNF
tumor necrosis factor
TSH
thyroid-stimulating hormone
TT3
total Triiodothyronine
TT4
total Thyroxine
TH
thyroid hormones
TBG
Thyroxine Binding Globulin

Keywords

Thyroid hormones
Cytokines
Albumin
Mortality

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