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Interleukin 27 as a sepsis diagnostic biomarker in critically ill adults.

Publication ,  Journal Article
Wong, HR; Lindsell, CJ; Lahni, P; Hart, KW; Gibot, S
Published in: Shock
November 2013

PURPOSE: We previously identified interleukin 27 (IL-27) as a sepsis diagnostic biomarker in critically ill children. The current study tested the performance of IL-27 alone and in combination with procalcitonin (PCT) for diagnosing sepsis in critically ill adults. METHODS: Serum samples were made available from a prior prospective study of sepsis biomarkers in critically ill adults. The primary analysis used receiver operating characteristic curves to evaluate the performance of IL-27 and PCT. Secondary analysis explored IL-27 performance in subgroups of patients with sepsis secondary to lung and nonlung sources of infection. The net reclassification improvement was used to estimate the incremental predictive ability of IL-27 compared with PCT alone. Classification and regression tree analysis was used to generate an IL-27- and PCT-based decision tree. RESULTS: There were 145 patients with sepsis and 125 without sepsis. The receiver operating characteristic curve for IL-27 was inferior (area under the curve [AUC], 0.68; 95% confidence interval [CI], 0.62-0.75) to that of PCT (AUC, 0.84; 95% CI, 0.79-0.89). Similar findings were observed when comparing patients with a lung source of infection and those without sepsis. For sepsis patients with a nonlung source of infection, adding IL-27 to PCT improved discrimination (net reclassification improvement = 0.685; P < 0.001). The AUC for the classification and regression tree-derived decision tree was 0.92 (95% CI, 0.88-0.96) and was significantly greater than that of PCT alone. CONCLUSIONS: When used in combination with PCT, IL-27 may improve classification of critically ill adults with sepsis secondary to a nonlung source of infection.

Duke Scholars

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Published In

Shock

DOI

EISSN

1540-0514

Publication Date

November 2013

Volume

40

Issue

5

Start / End Page

382 / 386

Location

United States

Related Subject Headings

  • Sepsis
  • Sensitivity and Specificity
  • Retrospective Studies
  • Respiratory Tract Infections
  • Protein Precursors
  • Predictive Value of Tests
  • Lung Diseases
  • Interleukin-27
  • Humans
  • Emergency & Critical Care Medicine
 

Citation

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Wong, H. R., Lindsell, C. J., Lahni, P., Hart, K. W., & Gibot, S. (2013). Interleukin 27 as a sepsis diagnostic biomarker in critically ill adults. Shock, 40(5), 382–386. https://doi.org/10.1097/SHK.0b013e3182a67632
Wong, Hector R., Christopher J. Lindsell, Patrick Lahni, Kimberly W. Hart, and Sebastien Gibot. “Interleukin 27 as a sepsis diagnostic biomarker in critically ill adults.Shock 40, no. 5 (November 2013): 382–86. https://doi.org/10.1097/SHK.0b013e3182a67632.
Wong HR, Lindsell CJ, Lahni P, Hart KW, Gibot S. Interleukin 27 as a sepsis diagnostic biomarker in critically ill adults. Shock. 2013 Nov;40(5):382–6.
Wong, Hector R., et al. “Interleukin 27 as a sepsis diagnostic biomarker in critically ill adults.Shock, vol. 40, no. 5, Nov. 2013, pp. 382–86. Pubmed, doi:10.1097/SHK.0b013e3182a67632.
Wong HR, Lindsell CJ, Lahni P, Hart KW, Gibot S. Interleukin 27 as a sepsis diagnostic biomarker in critically ill adults. Shock. 2013 Nov;40(5):382–386.

Published In

Shock

DOI

EISSN

1540-0514

Publication Date

November 2013

Volume

40

Issue

5

Start / End Page

382 / 386

Location

United States

Related Subject Headings

  • Sepsis
  • Sensitivity and Specificity
  • Retrospective Studies
  • Respiratory Tract Infections
  • Protein Precursors
  • Predictive Value of Tests
  • Lung Diseases
  • Interleukin-27
  • Humans
  • Emergency & Critical Care Medicine