Cytokine levels predict 30-day mortality in octogenarians and nonagenarians with community-acquired pneumonia: a retrospective observational study
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To analyze the value of cytokines (tumor necrosis factor [TNF]-α, interleukin [IL]-1β, IL-6, IL-8, IL-10) as predictors of mortality at 30 days in octogenarians and nonagenarians hospitalized in an internal medicine unit for community-acquired pneumonia (CAP). An observational, analytical, retrospective cohort study was conducted in the Department of Internal Medicine at Alicante General University Hospital between January 2014 and December 2015. Blood samples were frozen at − 80 °C, and cytokines were measured by ELISA. We included 115 patients, of whom 54% were men, with a mean age of 86.4 (standard deviation 4.5) years. There is a moderate correlation between IL-10 levels and CURB-65 score (p < 0.001) and a weak correlation with creatinine levels (p = 0.012) and urea levels (p = 0.032). Forty-five (39.1%) patients died within 30 days. In a multivariate analysis, the variables associated with mortality at 30 days were the following: age (adjusted odds ratio [ORa] 1.134, 95% confidence interval [CI] 1.02, 1.26), male sex (ORa 2.85, 95% CI 1.14, 7.14), IL-8 of 19 pg/mL or more (ORa 4.09, 95% CI 1.67, 10.01), and IL-10 of 11.29 pg/mL or more (ORa 4.00, 95% CI 1.58, 10.12). High IL-8 and IL-10 levels were shown to predict 30-day mortality in elderly patients with CAP. The inflammatory response in these patients seems to condition their prognosis. Further research in this line would provide more understanding about the physiopathological mechanisms and potential therapeutic targets for improving survival.
KeywordsCommunity acquired pneumonia Interleukin-8 Interleukin-10 Mortality Aged 80 and over
The authors acknowledge our gratitude to all the patients who participated in this study.
H.P. collected the data and wrote the manuscript.
G.M. performed the immunology procedures and wrote the manuscript.
M.C., and E.C. performed the immunology procedures.
J.P. designed the study and wrote the manuscript.
J.M.R. designed the study, collected the data, and wrote the manuscript.;
H.P., G.M., M.C., E.C., J.P., G.G., and J.M.R. critically revised the intellectual content of the manuscript.
This study was supported by a grant (NI-13/2012) from Research Foundation of the General University Hospital of Alicante [Fundación para la Investigación del Hospital General Universitario de Alicante] and a grant (UGP-14-272) from the Foundation for promoting Health and Biomedical Research in the Valencian Region [Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana] (FISABIO)-ALICANTE.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
The Research Ethics Committee of General University Hospital of Alicante (Spain) approved the study.
We obtained written informed consent from each patient for study inclusion and for the voluntary donation of research biospecimens to the biobank.
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