Prognostic value of cytokines in SIRS general medical patients

We studied 174 patients with SIRS criteria, 45 with sepsis, eight with seve re sepsis and 13 with septic shock. Serum TNF-alpha, IL-6, IL-8 and IL-10 l evels were raised in SIRS patients, even in those cases in which an infecti on could not be documented, and more intensely in severe sepsis and in pati ents who died (11%). The slope of the regression line between IL-10 and TNF -alpha was sharper in patients with severe sepsis and in those who died; an imbalance between pro- and anti-inflammatory cytokines may be related to p oor prognosis. Increased IL-6 and IL-10, decreased muscle mass, raised BUN and low body temperature were all independently related to prognosis. (C) 2 001 Academic Press.