Predictive value of systemic inflammatory markers in patients with severe ischemic stroke and multiple organ failure

   Multiple organ failure (MOF) in patients with severe ischemic stroke (IS) determines the severity of the clinical course and appear an unfavorable prognostic factor for the outcome of the disease. Changes in the concentration of inflammatory mediators in the blood serum, including interleukin-6 (IL-6), interleukin-10 (IL-10), procalcitonin (PCT) and C-reactive protein (CRP), may have a prognostic value in the outcome assessing.

   The aim of the research is to reveal the prognostic value of the inflammatory markers concentration in patients with severe IS and MOF.

   Materials and methods. A prospective observational study included 30 patients with severe IS. To determine and assess the severity of MOF, scales SAPS II, SOFA were used on the 1^st and 5^th days of hospitalization. A fatal outcome within 28 days from the onset of the disease was accepted as an unfavorable. The serum concentration of IL-6, IL-10, PCT and CRP was determined by enzyme-linked immunosorbent assay on the 1^st and 5^th days of hospitalization.

   Results. In the group of patients with an unfavorable outcome, compared with surviving patients, on the 5^th day of hospitalization, a higher concentration of IL-6 (p = 0.0136) and PCT (p = 0.0289), a greater increase in the concentration of IL-6 from the 1^st to 5^th day (p = 0.0136) were observed. According to the ROC-analysis, IL-6 has the highest prognostic ability: area under ROC curve (AUC) is 0,838, in optimal cut-off point value of 37,51 pg/ml sensitivity of predictor is 85,7 % and specificity is 73,3 %. PCT characterize by a good level of discrimination (AUC 0,80), IL-10 has middle prognostic ability (AUC 0,737).

   Conclusion. The concentration of markers of systemic inflammation and its dynamics in the acute period are a significant prognostic factor in the outcome of severe IS with the MOF.

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