Clinical utility of serum interleukin-6 in predicting outcomes in pediatric intensive care unit

Harini Venugopal; A. Sai Sneha Reddy

doi:10.18203/2349-3291.ijcp20262784

Authors

Harini Venugopal Department of Pediatrics, Mysore Medical College, Mysore, Karnataka, India
A. Sai Sneha Reddy Department of Pediatrics, Manipal Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20262784

Keywords:

Interleukins, PELOD, Prognosis

Abstract

Background: Early identification of critically ill children at high risk of mortality is essential for timely intervention. Biomarkers reflecting the inflammatory response may improve prognostication beyond conventional severity scores. This study evaluated the prognostic utility of serial serum interleukin-6 (IL-6) levels in children requiring intensive care.

Methods: This observational cross-sectional study included 45 children aged 1 month to 18 years admitted to a pediatric intensive care unit. Serum IL-6 levels were measured at admission, 24 hours, and 72 hours. The severity of illness was assessed by the pediatric logistic organ dysfunction-2 (PELOD-2) score. The primary outcome was in-hospital mortality, while secondary outcomes were duration of pediatric intensive care unit stay, hospital stay, and need for respiratory and inotropic support.

Results: Five (11.1%) children died during hospitalization. The median IL-6 levels at 24 hours and 72 hours were significantly higher in non-survivors compared to survivors, with values of 1122 (IQR 1305) pg/ml versus 564 (IQR 153) pg/ml at 24 hours, and 1263 (IQR 626) pg/ml versus 82 (IQR 191) pg/ml at 72 hours, both with p values less than 0.0001. Non-survivors had significantly higher IL-6 levels at 24 and 72 hours than survivors (p<0.001). Higher IL-6 levels were also associated with illness severity.

Conclusions: Serial serum IL-6 measurement is a valuable prognostic biomarker in children requiring intensive care. Incorporating serial IL-6 estimation with clinical severity assessment may facilitate early risk stratification and optimize management in the pediatric intensive care unit.

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