Prognostic Values of Tumor Necrosis Factor/Cachectin, Interleukin-l, Interferon- , and Interferon- in the Serum of Patients with Septic Shock

Abstract

Serum concentrations of immunoreactive tumor necrosis factor/cachectin (TNF), interleukin-1β (IL-1β), interferon-γ (IFNγ, and interferon-α (IFNα) were prospectively measured in 70 patients with septic shock to determine their evolution and prognostic values. In a univariate analysis, levels of TNF (P = .002) and IL-1β (P = .05) were associated with the patient's outcome, but not IFNα (P = .15) and IFNγ (P = .26). In contrast, in a stepwise logistic regression analysis, the severity of the underlying disease (P = .01), the age of the patient (P = .02), the documentation of infection (nonbacteremic infections vs. bacteremias, P = .03), the urine output (P = .04), and the arterial pH (P = .05) contributed more significantly to prediction of patient outcome than the serum levels of TNF (P = .07). After 10 days, the median concentration of TNF was undetectable P = .002) in the nonsurvivors. Thus, in patients with septic shock due to various gram-negative bacteria, other parameters than the absolute serum concentration of immunoreactive TNF contributed significantly to the prediction of outcome.