Model of Von Dossow et al for Identifying a Surgical Patient with Hospital-Acquired Pneumonia at Risk for Septic Shock Using Serum Lymphokine Levels

 

Patient selection: surgical patients with hospital-acquired pneumonia

 

Lymphokines which best predicted progression:

(1) IL-1 beta

(2) IL-6

(3) IL-8

(4) IL-10

Lymphokine	Level Seen in Patients Who Developed Septic Shock
IL-1 beta	> 1.4 pg/mL
IL-6	>= 166 pg/mL
IL-8	>= 106 pg/mL
IL-10	> 24 pg/mL

from Table 4, page R666

 

The presence of an increase in one or more cytokines was associated with progression to septic shock.

 

Performance:

• The area under the ROC curve for the different assays was around 0.80.

• Other measures such as WBC count or CRP were poor predictors of progression.

 

Limitations:

• The normal reference range for the various lymphokines was not specified although the assay (Quantikine Immunoassay, R&D Systems) and detection limits were given.