RT Journal Article
SR Electronic
T1 Factors associated with inflammatory cytokine patterns in community-acquired pneumonia
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00407-2010
DO 10.1183/09031936.00040710
A1 R. Martínez
A1 R. Menéndez
A1 S. Reyes
A1 E. Polverino
A1 C. Cillóniz
A1 A. Martínez
A1 C. Esquinas
A1 X. Filella
A1 P. Ramírez
A1 A. Torres
YR 2010
UL http://erj.ersjournals.com/content/early/2010/07/01/09031936.00040710.abstract
AB Raised systemic levels of interleukin-6 and interleukin-10 cytokine have been associated with poorer outcome in community-acquired pneumonia. The aim of our study was to identify potential associated factors with increased levels of interleukin-6, interleukin-10, or both cytokine.We performed a prospective study of 685 patients admitted to hospital with community-acquired pneumonia. Interleukin-6 and interleukin-10 were measured in blood in the first 24 hours.Thirty-day mortality increased from 4.8% to 11.4% (p: 0.003) when both cytokines were higher than the median. Independent associated factors with an excess of interleukin-6 were neurologic disease, confusion, serum sodium <130 mEq·L−1, pleural effusion, and bacteremia. The associated factors for an excess of interleukin-10 were respiratory rate ≥30 rpm, systolic blood pressure <90 mm Hg and glycemia ≥250 mg·dL−1. The independent associated factors for an excess of both cytokines were confusion, systolic blood pressure <90 mmHg, pleural effusion, and bacteremia. Protective factors were prior antibiotic treatment and pneumococcal vaccination.Different independent factors are related to an excess of interleukin-6 and interleukin-10. Confusion, hypotension, pleural effusion, and bacteremia are associated with the inflammatory profile with the highest mortality rate, whereas antipneumococcal vaccination and previous antibiotic treatment appear as protective factors.