Longitudinal measurements of inflammatory mediators in patients at risk of sepsis in the Emergency Department
Authors' conclusion
In conclusion, Sepsis status and organ dysfunction severity were associated with distinct inflammatory biomarker levels and kinetics. IL6 showed a unique time-dependent relationship, whereas the dynamics of TNFRSF1A, IL8 and PCT showed exploratory associations with survival.
Study context
- Population
- Adults presenting to the ED with suspected infection and NEWS2 ≥3214 screened
- Participants
- 173 adults
- Outcome
- Biomarker kinetics (baseline, 4 and 24 h)
- Follow-up
- 24 h
Methodological detailssingle-centre, Linear and nonlinear mixed-effects models; joint models for in-hospital mortality
- Single-centre
- Linear and nonlinear mixed-effects models; joint models for in-hospital mortality
Main finding
As reported in the abstract
- Time-dependent decrease in IL10
- β −0.016 (95%CI −0.028 to −0.004)
- Time-dependent decrease in IL1RN
- β −0.014 (95%CI −0.024 to −0.004)
- Time-dependent decrease in IL6, first spline 0-4 h
- β −1.021 (95%CI −1.609 to −0.433)
- Sepsis associated with higher IL1RN
- β 0.378 (95%CI 0.153-0.603)
- Sepsis associated with higher TNFRSF1A
- β 0.40 (95%CI 0.21-0.58)
- Sepsis-time interaction only for IL6, second spline 4-24 h (β, CI95% −0.653 to-0.007)
- −0.33
- Increasing SOFA correlated with elevated IL10 (β; p < 0.01)
- 0.048
- Increasing SOFA correlated with elevated IL1RN (β; p < 0.01)
- 0.044
- Increasing SOFA correlated with elevated CCL2 (β; p < 0.01)
- 0.046
- Increasing SOFA correlated with elevated TNFRSF1A (β; p < 0.01)
- 0.050
- Increasing SOFA correlated with elevated procalcitonin (PCT) (β; p < 0.01)
- 2.15
- SOFA-time interaction only for IL6, first spline 0-4 h
- β 0.122 (95%CI 0.006 to 0.238)
- SOFA-time interaction for IL6, second spline 4-24 h
- β −0.080 (95%CI −0.133 to −0.027)
Observational data: associations, not effects.
Further findings
Sepsis development
- Developed sepsis
- 137(79%)
In-hospital mortality (joint survival models) · first 24 h
HR
- Longitudinal IL8
- 0.655 (95%CrI 0.582-0.728)
- Longitudinal TNFRSF1A
- 0.505 (95%CrI 0.419-0.682)
- Longitudinal PCT
- 1.004 (95%CrI 1.001-1.008)
- IL8 and TNFRSF1A unexpected inverse association with survival; overall discriminatory performance modest
Original publication
Longitudinal measurements of inflammatory mediators in patients at risk of sepsis in the Emergency Department. Ann Intensive Care. Published 3 October 2026. doi:10.
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