Correlation between Level of Interleukin-6, Interleukin-10 and Ratio of Interleukin with PELOD-2 Score as Predictor of Outcome in Children with Sepsis

Faiza Risty  Aryanti Septarini; Muhammad Supriatna Toto  Saputra; Wistiani Wistiani; Omega Mellyana

doi:10.35582/ijcpch.v1i4.32

Faiza Risty Aryanti Septarini doctor
Muhammad Supriatna Toto Saputra Department of Child Health, Faculty of Medicine, Universitas Diponegoro/Kariadi Hospital, Semarang
Wistiani Wistiani Department of Child Health, Faculty of Medicine, Universitas Diponegoro/Kariadi Hospital, Semarang
Omega Mellyana Department of Child Health, Faculty of Medicine, Universitas Diponegoro/Kariadi Hospital, Semarang

DOI: https://doi.org/10.35582/ijcpch.v1i4.32

Keywords: interleukin-6, interleukin-10, interleukin ratio, sepsis, prognosis

Abstract

Background: Sepsis consist of inflammatory and anti-inflammatory processes. Biomarker as IL-6, IL-10 dan ratio of both interleukin has been associated with severity of sepsis which correlate with severity organ disfunction and usefull prognostic marker in patient with sepsis. One of sistem scoring that aimed to describe the severity of organ dysfunction is PELOD-2 score.

Aim: To prove that IL-6, IL-10 plasma concentrations and ratio IL-6/IL-10 can be used to predict outcome in children with sepsis by using PELOD-2 score.

Methods: An analytic observational study in 31 children with sepsis in Dr. Kariadi general hospital, Semarang, from February to July 2019. The relationship between changes in IL-6, IL-10 and IL ratio with PELOD-2 scores were analyzed by the Pearson or Spearman test. Cut-off points for IL-6, IL-10 and IL ratio to predict the outcome of sepsis were determined using the ROC curve.

Results: Thirty one children with sepsis were included in the study. Nine children (31%) died during the study period. There were significant differences in IL-6 levels (D₅-end observation), IL-10 levels (D₀) and the IL-6 / IL-10 ratio (D₀-end observation) between children death outcomes with life. The IL-6/IL-10 ratio with a cut-off point 1.35 (AUC 0.78 ± 0.1; p = 0.019) on D5, IL-6 level ≥17.15 pg/ml (AUC 0.85 ± 0.80; p = 0.004) and IL6 / IL-10 ratio ≥ 1.23 (AUC 0.89 ± 0.08; p = 0.01) at the end of monitoring can be used as an indicator of multiorgan damage.There was significant relationship between changes in IL-6 levels ≥ 1.25 pg/ml with increased multiorgan failure (RR 80; 95% CI 6.33 - 101.95; p <0.001) at time interval D₀-end observation, especially in the initial 5 days ≥ 1.05 pg/ml (RR 1.27; 95% CI 1.21 – 31.94; p = 0.004 ). Type of pathogen becomes a factor of the assault in this study.

Conclusion: Levels of IL-6 (D₅ and end observation), IL-10 (D₀) and the ratio of IL-6/IL-10 (D₀, D₅ and end observation) differed significantly between died with live outcomes. IL-6, IL-10 and IL-6 / IL-10 ratio can be used together in predicting multi-organ failures at D₅ and end of monitoring.