Prognostic value of the levels of IL-6 and TNF-α, and APACHE Ⅱ score in elderly patients with severe infection in ICU

ObjectiveTo observe the prognostic value of the levels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α), and acute physiology and chronic health score(APACHE)Ⅱ score in elderly patients with severe infection in intensive care unit(ICU).

MethodsSeventy-eight elderly patients were divided into the sepsis group(n=35), severe sepsis group(n=24) and septic shock group(n=19) according to the severity of the disease.According to the prognosis, the patients were divided into the survival group(n=60) and death group(n=18).Receiver operating characteristic (ROC)curve was used to evaluate the prognostic value of each index.

ResultsThe levels of IL-6 and TNF-α, and APACHEⅡ score of patients in the sepsis group, severe sepsis group and septic shock group gradually increased(P < 0.05 to P < 0.01).The IL-6 level and APACHEⅡ score in survival group were significantly lower than those in death group(P < 0.01), and there was no statistical significance in the TNF-α level between two groups(P>0.05).The levels of IL-6 and TNF-α, and APACHEⅡ score were all positively correlated(P < 0.05 to P < 0.01).The area under the ROC curve of the combined detection of IL-6, TNF-α and APACHE Ⅱ scores was 0.854, which was significantly higher than that of the three alone(0.678, 0.600 and 0.691, respectively) (P < 0.05).

ConclusionsThe levels of IL-6 and TNF-α, and APACHE Ⅱ score have certain values in evaluating the prognosis of elderly patients with severe infection in ICU, and the combined detection can improve the prognosis value.