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Prognostic Values of Tumor Necrosis Factor/Cachectin, Interleukin-l, Interferon-α, and Interferon-γ in the Serum of Patients with Septic Shock

Calandra, Thierry ; Baumgartner, Jean-Daniel ; Grau, Georges E. ; Wu, Mei-Miau ; Lambert, Paul-Henri ; Schellekens, Joop ; Verhoef, Jan ; Glauser, Michel P.

In: Journal of Infectious Diseases, 1990, vol. 161, no. 5, p. 982-987

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    Titre
    • Prognostic Values of Tumor Necrosis Factor/Cachectin, Interleukin-l, Interferon-α, and Interferon-γ in the Serum of Patients with Septic Shock
    Auteur
    • Calandra, Thierry. From the Division of Infectious Diseases, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne
    • Baumgartner, Jean-Daniel. From the Division of Infectious Diseases, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne
    • Grau, Georges E.. From the Division of Infectious Diseases, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne
    • Wu, Mei-Miau. From the Division of Infectious Diseases, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne
    • Lambert, Paul-Henri. From the Division of Infectious Diseases, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne
    • Schellekens, Joop. From the Division of Infectious Diseases, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne
    • Verhoef, Jan. From the Division of Infectious Diseases, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne
    • Glauser, Michel P.. From the Division of Infectious Diseases, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Journal of Infectious Diseases, 1990, vol. 161, no. 5, p. 982-987. The University of Chicago Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:296284
    Summary
    Serum concentrations of immunoreactive tumor necrosis factor/cachectin (TNF), interleukin-1β (IL-1β), interferon-γ (IFNγ, and interferon-α (IFNα) were prospectively measured in 70 patients with septic shock to determine their evolution and prognostic values. In a univariate analysis, levels of TNF (P = .002) and IL-1β (P = .05) were associated with the patient's outcome, but not IFNα (P = .15) and IFNγ (P = .26). In contrast, in a stepwise logistic regression analysis, the severity of the underlying disease (P = .01), the age of the patient (P = .02), the documentation of infection (nonbacteremic infections vs. bacteremias, P = .03), the urine output (P = .04), and the arterial pH (P = .05) contributed more significantly to prediction of patient outcome than the serum levels of TNF (P = .07). After 10 days, the median concentration of TNF was undetectable <100 pg/ml) in the survivors, whereas it remained elevated (305 pg/ml, P = .002) in the nonsurvivors. Thus, in patients with septic shock due to various gram-negative bacteria, other parameters than the absolute serum concentration of immunoreactive TNF contributed significantly to the prediction of outcome