Prognostic value of cytokines (TNF-α, IL-10, Leptin) and C-reactive protein serum levels in adult patients with nosocomial sepsis

Abstract

Objectives: The purpose of this trial was to investigate in patients with sepsis, the correlation between prognosis of disease and factors, which influence prognosis like gender, focus of infection, bacterial growth in blood culture, growing pathogens in addition to serum levels of cytokines (TNF-a, IL-10, leptin) and C-reactive protein. Material and methods: Forty-six adult patients with sepsis and 55 healthy adults as control group were enrolled in this study. Serum cytokine (TNF-a, IL-10 and leptin) levels were determined by ELISA method and C-reactive protein (CRP) levels were measured by nephelometric method. Serum cytokine and CRP levels on day 0 (initial), day 3 and day 5 were compared in surviving sepsis patients and patients who died because of sepsis. Results: Serum IL-10 level on day 0 (initial) of adult patients who died as a result of sepsis was found to be higher than surviving patients and the difference was statistically significant (p=0.025). On 3rd day of treatment, serum TNF-a and CRP levels of patients who dies because of sepsis were higher than values of surviving patients (for TNF-a p=0.033, for CRP p=0.026). In adult patient group with sepsis who died on the 5th day of treatment, serum TNF-a level was significantly higher than levels in surviving patients (p=0.030). Conclusion: It was determined that in patients who died due to sepsis, initial serum IL-10 level, TNF- a and CRP levels on 3rd day of treatment and finally on 5th day of treatment, only serum TNF- a level was higher than surviving patients. We believe that determining serum TNF-a and IL-10 levels in patients with sepsis before and during treatment will help clinicians to clarify prognosis and enable them to implement appropriate treatment modifications.