Sepsis, a life-threatening condition arising from a dysregulated immune response to infection, is a significant health burden globally. Interleukin-6 (IL-6), an inflammatory cytokine produced by immune cells as a response to infection and tissue damage, plays a key role in the pathogenesis of sepsis. This systematic review and meta-analysis aimed to investigate the association of the baseline plasma levels of IL-6, and the dynamic change in these levels over a timespan of 96 h, with short-term mortality. A systematic literature search was conducted across multiple databases. Studies were included if they assessed the independent prognostic value of IL-6 in adult sepsis patients, used well-defined sepsis criteria, and reported at least one IL-6 measurement. Pooled effect estimates for the association between IL-6 and 28–30-day mortality were determined using logistic regression and AUROC analysis. Thirty-one studies, encompassing 4566 patients, were included. While baseline IL-6 levels and 96 h IL-6 clearance were not significantly associated with mortality risk (pooled OR 1.001, 95% CI 0.999–1.003 and 1.019, 95% CI 0.925–1.112, respectively), AUROC analysis indicated moderate-to-good discriminatory power for both baseline (0.701, 95% CI 0.660–0.742) and 96 h IL-6 clearance (0.828, 95% CI 0.736–0.919) in predicting 28-day mortality. While not a strong independent predictor, IL-6 demonstrates some discriminatory ability, suggesting its potential value in conjunction with other biomarkers.
Background: The prognostic value of baseline inflammatory markers in sepsis remains controversial, with conflicting evidence regarding their association with mortality. The dynamic changes in these markers over time might offer additional insights into disease progression and patient outcomes. Methods: This retrospective observational study included 138 patients with severe infections. The inflammatory biomarkers procalcitonin (PCT), C-reactive protein (CRP), and lactate (LAC) were measured at three time points: upon hospital admission (baseline), approximately 24–48 h after admission (second measurement; M2), and 48–72 h after admission (third measurement; M3). The primary outcome was 30-day mortality. A Mann–Whitney U test was used to compare the biomarker levels between the survivors and non-survivors. A Spearman’s correlation was used to assess the relationships between the baseline parameters. A logistic regression and a receiver operating characteristic (ROC) curve analysis were employed to evaluate the prognostic value of the baseline markers and their dynamic changes. Results: The baseline LAC and SOFA score were significantly associated with 30-day mortality. The percentage decrease in PCT, CRP, and LAC from the baseline to M3 emerged as strong predictors of survival, with the ROC curve analysis demonstrating superior discriminatory ability compared to the baseline values. CRP_Delta exhibited the highest AUC (0.903), followed by PCT_Delta (0.843) and LAC_Delta (0.703). Conclusions: The dynamic changes in these inflammatory biomarkers, particularly PCT, CRP, and LAC, offer valuable prognostic information beyond their baseline levels in predicting 30-day mortality in severe infections. These findings highlight the importance of monitoring biomarker trends for early risk stratification and potential treatment guidance.
Background and Objectives: Effective communication in oncology is crucial, but challenging due to the complex information and emotional burden associated with a cancer diagnosis. This cross-sectional study investigated the communication preferences of 155 Romanian adults diagnosed with ENT cancers and explored the relationship between these preferences, their levels of psychological distress, and sociodemographic factors. Materials and Methods: Participants completed the KOPRA questionnaire, assessing communication preferences, and the Hospital Anxiety and Depression Scale (HADS) to measure psychological distress. Results: The results revealed that patients strongly prioritized active involvement in their care (Patient Participation and Patient Orientation—PPO) and open communication with healthcare providers (Effective and Open Communication—EOC). While emotional support was valued, it was considered less critical than PPO and EOC. Notably, communication about personal matters was deemed the least important aspect of communication. A high prevalence of psychological distress was observed, particularly among widowed individuals and females. No direct correlation was found between communication preferences and distress. Conclusions: These findings underscore the importance of shared decision-making, clear information exchange, and a patient-centered approach in the context of ENT cancer care, while also highlighting the need for routine screening and appropriate support for psychological well-being in this patient population.