الفهرس | Only 14 pages are availabe for public view |
Abstract Sepsis is a complicated syndrome resulting from the inappropriate expression of host factors in response to infection and is a major cause of death in patients that are hospitalized, in emergency departments (ED) and in critical care units. The purpose of the present study is to detect the possible association between baseline levels of Interleukin 10 & soluble CD 25 and early (7 days) sepsis associated mortality in addition to detection of correlation between baseline levels of Interleukin 10 & soluble CD 25 and other clinic laboratory variables in non-survivors in a cohort of Egyptian adults with sepsis. The evaluation and management of sepsis was consistent with the 2016 guidelines issued by the Surviving Sepsis Campaign. This study applied on 70 adults with sepsis and was done at Menoufia university hospitals. The present study revealed the following results: Mean age of included patients was 60 years, 60% of them were males, while 40% females. Pulmonary primary site of infection was found in 44% of patients. 41.4% of patients needed mechanical ventilation. Within studied patients, non-survival is highly significantly associated with lung infection. Regarding clinical data, non-survival is highly significantly associated with frequency of using ventilator than survivors. IL-10 and sCD25 are highly significantly higher in non-survivor cases than survivors. APTT, CRP, WBC are highly significantly higher in non-survivor cases than survivors. On the other hand, platelet is highly significantly lower in non-survivor cases than survivors. SOFA score is significantly higher in non-survivor cases than survivors. There is statistically highly significantly positive correlation between SOFA score and each of IL-10, sCD25. On the other hand, there is negative correlation between SOFA score and level of platelet. There is statistically highly significantly positive correlation between biomarkers IL-10&sCD25 and laboratory investigations (APTT, CRP, WBC). there is also statistically highly significant negative correlation between biomarkers IL- 10&sCD25 and level of platelets. By logistic regression analysis it was found that there is highly significant positive correlation between non-survival and each of using ventilator, levels of IL-10, sCD25, SOFA score and laboratory results of CRP, WBC. On the other hand, there is highly significant negative correlation between nonsurvival and platelets level. Sepsis triggers the production of a diverse array of cytokines that are proinflammatory and anti-inflammatory. While pro-inflammatory cytokines are necessary for controlling infection, their excessive production may lead to tissue and organ injury. The initial serum levels of IL-10 as the prognostic value of the outcome of patients with sepsis is expected to more comprehensive sepsis treatment to prevent complications and deaths. IL-10 and sCD25 gave a significant contribution to prognostic evaluation and early diagnosis of sepsis. SOFA score appeared to be a reliable prognostic tool in this subset of patient. The results of this study open doors for: More clarifying the sepsis scene via larger scale, longer time studies with reporting more sepsis outcomes alongside, the evaluation of other or additional proinflammatory & anti-inflammatory biomarkers would be recommended. Keeping pace with times extra polation of this kind of studies to patient with (covid-19 sepsis) is almost substantial. We hope for near future molecular researches to decode the precise roles of proinflammatory & anti-inflammatory proteoms in sepsis pathology, hence opening doors for drug discovery, therapeutic trials, hoping to improve sepsis outcomes. |