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Interleukin 6 is a prognostic indicator of outcome in severe intra‐abdominal sepsis

Levels of plasma cytokines and circulating endotoxin were assessed in 41 patients with severe intra‐abdominal sepsis. Comparison was made with the Acute Physiology And Chronic Health Evaluation (APACHE) II scoring system. Blood samples were taken within 24 h of onset of the sepsis syndrome and at serial times thereafter. Increased levels of interleukin (IL) 6 (range 50–25 500 pg/ml) were detectable in all patients with sepsis. Eighteen of the 19 deaths were attributable to sepsis and higher levels of IL‐6 at the onset of the sepsis syndrome correlated with a poor outcome. The sensitivity of IL‐6 concentration in predicting mortality was 86·4 per cent with a specificity of 78·9 per cent and an overall correct classification rate of 82·9 per cent. IL‐6 level was a better predictor than APACHE II score (sensitivity 72·7 per cent, specificity 57·9 per cent, correct classification rate 65·9 per cent). Levels of tumour necrosis factor α, IL‐1β and endotoxin did not correlate with mortality rate. Plasma IL‐6 concentrations may help in planning future strategies to decrease the mortality rate associated with sepsis.