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  1. Proinflammatory cytokines, measured in a mixed population on arrival in the emergency department, are related to mortality and severity of disease.

    Article - En anglais

    Carlstedt F, Lind L, Lindahl B (University Hospital of Uppsala, Sweden).

    Proinflammatory cytokines, measured in a mixed population on arrival in the emergency department, are related to mortality and severity of disease.

    Objectives

    To investigate whether serum levels of tumour necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) are related to mortality and severity of disease in patients admitted to the Emergency Department (ED).

    Design

    Prospective cohort study.

    Setting.

    Emergency Department of a tertiary university hospital.

    Subjects

    A total of 140 patients admitted to the ED, representing common acute medical diseases, such as stroke, obstructive lung disease, heart failure, myocardial infarction, angina pectoris, infectious diseases and acute abdominal disorders.

    Main outcome measures

    APACHE II score at admission, hospital mortality and length of stay in hospital (LOS).

    Results

    A moderate rise in cytokine levels (IL-6 : 50-300 ng L-1, TNF-alpha ; 10-70 ng L-1) was found in all diagnosis-groups, with the most pronounced elevation seen in patients with acute abdominal disorders (up to 6900 ng L-l).

    IL-6 on arrival to the ED was significantly correlated to the APACHE II score (r=0.48, P<0.0001), LOS (r=0.36, P<0.0001) and was elevated in nonsurvivors (n=9) compared to those who did survive.

    TNF-alpha on arrival showed a significant correlation to LOS (r=0.36.

    P<0.0001) and APACHE II (r=0.41, P<0.0001), but was not associated to later mortality. (...)

    Mots-clés Pascal : Service urgence, Epidémiologie, Etude cohorte, Facteur nécrose tumorale alpha, Interleukine 6, Facteur risque, Mortalité, Indice gravité, Evaluation, Homme, Suède, Europe, Hôpital, Réanimation, Cytokine, Organisation santé, APACHE II score

    Mots-clés Pascal anglais : Emergency department, Epidemiology, Cohort study, Tumor necrosis factor alpha, Interleukin 6, Risk factor, Mortality, Severity score, Evaluation, Human, Sweden, Europe, Hospital, Resuscitation, Cytokine, Public health organization

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0028156

    Code Inist : 002B27B15. Création : 17/04/1998.