Plasma cytokine levels predict response to corticosteroids in septic shock
(2016) In Intensive Care Medicine 42(12). p.1970-1979- Abstract
Purpose: To investigate if plasma cytokine concentrations predict a beneficial response to corticosteroid treatment in septic shock patients. Methods: A cohort of septic shock patients in whom a panel of 39 cytokines had been measured at baseline (n = 363) was included. Patients who received corticosteroids were propensity score matched to non-corticosteroid-treated patients. An optimal threshold to identify responders to corticosteroid treatment for each cytokine was defined as the concentration above which the odds ratio for 28-day survival between corticosteroid- and non-corticosteroid-treated patients was highest. Results: Propensity score matching partitioned 165 patients into 61 sets; each set contained matched corticosteroid- and... (More)
Purpose: To investigate if plasma cytokine concentrations predict a beneficial response to corticosteroid treatment in septic shock patients. Methods: A cohort of septic shock patients in whom a panel of 39 cytokines had been measured at baseline (n = 363) was included. Patients who received corticosteroids were propensity score matched to non-corticosteroid-treated patients. An optimal threshold to identify responders to corticosteroid treatment for each cytokine was defined as the concentration above which the odds ratio for 28-day survival between corticosteroid- and non-corticosteroid-treated patients was highest. Results: Propensity score matching partitioned 165 patients into 61 sets; each set contained matched corticosteroid- and non-corticosteroid-treated patients. For 13 plasma cytokines threshold concentrations were found where the odds ratio for survival between corticosteroid- and non-corticosteroid-treated patients was significant (P <0.05). CD40 ligand was associated with the highest odds ratio and identified 21 % of the patients in the propensity score matched cohort as responders to corticosteroid treatment. Combinations of triplets of cytokines with a significant odds ratio, using the thresholds identified above, were tested to find a higher proportion of responders. IL3, IL6, and CCL4 identified 50 % of the patients in the propensity score matched cohort as responders to corticosteroid treatment. The odds ratio for 28-day survival was 19 (95 % CI 3.5–140, P = 0.02) with a concentration above threshold for a least one of these cytokines. Conclusion: Plasma concentration of selected cytokines is a potential predictive biomarker to identify septic shock patients that may benefit from treatment with corticosteroids.
(Less)
- author
- Bentzer, Peter LU ; Fjell, Chris ; Walley, Keith R. ; Boyd, John and Russell, James A.
- organization
- publishing date
- 2016-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Corticosteroids, Cytokines, Predictive biomarker, Propensity score matching, Septic shock
- in
- Intensive Care Medicine
- volume
- 42
- issue
- 12
- pages
- 10 pages
- publisher
- Springer Science and Business Media B.V.
- external identifiers
-
- scopus:84963686144
- pmid:27071387
- wos:000387846500015
- ISSN
- 0342-4642
- DOI
- 10.1007/s00134-016-4338-z
- language
- English
- LU publication?
- yes
- id
- e40db47d-dff4-455a-a1ff-bc17e703ec45
- date added to LUP
- 2016-05-12 13:53:46
- date last changed
- 2025-10-14 09:44:42
@article{e40db47d-dff4-455a-a1ff-bc17e703ec45,
abstract = {{<p>Purpose: To investigate if plasma cytokine concentrations predict a beneficial response to corticosteroid treatment in septic shock patients. Methods: A cohort of septic shock patients in whom a panel of 39 cytokines had been measured at baseline (n = 363) was included. Patients who received corticosteroids were propensity score matched to non-corticosteroid-treated patients. An optimal threshold to identify responders to corticosteroid treatment for each cytokine was defined as the concentration above which the odds ratio for 28-day survival between corticosteroid- and non-corticosteroid-treated patients was highest. Results: Propensity score matching partitioned 165 patients into 61 sets; each set contained matched corticosteroid- and non-corticosteroid-treated patients. For 13 plasma cytokines threshold concentrations were found where the odds ratio for survival between corticosteroid- and non-corticosteroid-treated patients was significant (P <0.05). CD40 ligand was associated with the highest odds ratio and identified 21 % of the patients in the propensity score matched cohort as responders to corticosteroid treatment. Combinations of triplets of cytokines with a significant odds ratio, using the thresholds identified above, were tested to find a higher proportion of responders. IL3, IL6, and CCL4 identified 50 % of the patients in the propensity score matched cohort as responders to corticosteroid treatment. The odds ratio for 28-day survival was 19 (95 % CI 3.5–140, P = 0.02) with a concentration above threshold for a least one of these cytokines. Conclusion: Plasma concentration of selected cytokines is a potential predictive biomarker to identify septic shock patients that may benefit from treatment with corticosteroids.</p>}},
author = {{Bentzer, Peter and Fjell, Chris and Walley, Keith R. and Boyd, John and Russell, James A.}},
issn = {{0342-4642}},
keywords = {{Corticosteroids; Cytokines; Predictive biomarker; Propensity score matching; Septic shock}},
language = {{eng}},
number = {{12}},
pages = {{1970--1979}},
publisher = {{Springer Science and Business Media B.V.}},
series = {{Intensive Care Medicine}},
title = {{Plasma cytokine levels predict response to corticosteroids in septic shock}},
url = {{http://dx.doi.org/10.1007/s00134-016-4338-z}},
doi = {{10.1007/s00134-016-4338-z}},
volume = {{42}},
year = {{2016}},
}