Ontology highlight
ABSTRACT: Rationale
Interventional clinical trials involving children with septic shock would benefit from an efficient preenrollment stratification strategy.Objectives
To test the predictive value of interleukin (IL)-8 for 28-day mortality in pediatric septic shock.Methods
A training data set (n = 40) identified a serum IL-8 of greater than 220 pg/ml as having a 75% sensitivity and specificity for predicting 28-day mortality. This cutoff was then subjected to a series of validation steps.Measurements and main results
Subjects were drawn from two large, independent pediatric septic shock databases. Prospective application of the IL-8 cutoff to validation data set 1 (n = 139) demonstrated 78% sensitivity and 64% specificity for 28-day mortality. A serum IL-8 level of 220 pg/ml or less, however, had a negative predictive value for 28-day mortality of 95% in validation data set 1, which was subsequently applied to an independently generated data set of children with septic shock (validation set 2, n = 193). A serum IL-8 level of 220 pg/ml or less had a negative predictive value for 28-day mortality of 94% when applied to validation set 2.Conclusions
A serum IL-8 level of 220 pg/ml or less, obtained within 24 hours of admission, predicts a high likelihood of survival in children with septic shock. We propose that IL-8 can be used to exclude such patients from interventional clinical trials and ultimately derive a study population with a more favorable risk to benefit ratio when subjected to a study agent.
SUBMITTER: Wong HR
PROVIDER: S-EPMC2542425 | biostudies-literature | 2008 Aug
REPOSITORIES: biostudies-literature
Wong Hector R HR Cvijanovich Natalie N Wheeler Derek S DS Bigham Michael T MT Monaco Marie M Odoms Kelli K Macias William L WL Williams Mark D MD
American journal of respiratory and critical care medicine 20080529 3
<h4>Rationale</h4>Interventional clinical trials involving children with septic shock would benefit from an efficient preenrollment stratification strategy.<h4>Objectives</h4>To test the predictive value of interleukin (IL)-8 for 28-day mortality in pediatric septic shock.<h4>Methods</h4>A training data set (n = 40) identified a serum IL-8 of greater than 220 pg/ml as having a 75% sensitivity and specificity for predicting 28-day mortality. This cutoff was then subjected to a series of validatio ...[more]