Prognostic value of TNF-α, PCT, IL-8, and HBP, combined with APACHE II score in patients with sepsis.

INTRODUCTION

This study evaluated the prognostic value of serum cytokines tumor necrosis factor-alpha (TNF-α), procalcitonin (PCT), interleukin-8 (IL-8), and heparin binding protein (HBP); combined with acute physiology and chronic health evaluation II (APACHE II) score in sepsis patients.

METHODOLOGY: Patients were divided into sepsis and septic shock groups based on sepsis-3 criteria, with non-sepsis individuals as controls. Serum TNF-α, PCT, IL-8, and HBP levels; and APACHE II scores were recorded upon intensive care unit (ICU) admission. The diagnostic value was evaluated using receiver operating characteristic (ROC) curves and areas under the curves (AUCs).

RESULTS

Correlation analysis revealed that serum TNF-α (r = 0.701), PCT (r = 0.623), IL-8 (r = 0.617), and HBP (r = 0.721) were positively correlated with the APACHE II score (p < 0.05). Serum TNF-α, PCT, IL-8, HBP levels, and APACHE II scores were significantly higher in non-survivors than survivors (p < 0.05). The AUC for combined indicators in predicting mortality was 0.913 (confidence interval, CI: 0.861-0.912), significantly higher than individual indicators. HBP showed AUC of 0.798 (CI: 0.707-0.879) and APACHE II 0.769 (CI: 0.782-0.892). The combined prediction demonstrated 96.21% sensitivity and 79.34% specificity.

CONCLUSIONS

Serum TNF-α, PCT, IL-8, and HBP levels influenced sepsis patient prognosis, and their combined detection with APACHE II score provided a high predictive value for patient outcomes.