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Predictive value of intrathecal interleukin-6 for ventriculostomy-related Infection
B Schoch1, J P Regel, A Nierhaus
1Department of Neurosurgery, University Hospital, Essen, Germany. beate.schoch@uk-essen.de
Zentralblatt Fur Neurochirurgie
|April 30, 2008
Summary
Intrathecal interleukin-6 (IL-6) levels can predict ventriculostomy-related infection (VRI) in neurosurgical patients one day earlier than traditional methods. This early detection using IL-6 (CSF) aids in timely treatment of VRI.
Area of Science:
- Neurosurgery
- Infectious Disease
- Biomarker Discovery
Background:
- Ventriculostomy-related infection (VRI) diagnosis is challenging in neurosurgical patients due to blood-stained cerebrospinal fluid (CSF).
- Traditional CSF parameters (cell count, total protein) have limitations in early VRI detection.
Purpose of the Study:
- To evaluate the predictive value of intrathecal interleukin-6 (IL-6) for VRI in neurosurgical patients.
- To compare IL-6 (CSF) with classical diagnostic CSF parameters for VRI detection.
Main Methods:
- Prospective analysis of 75 neurosurgical patients with external ventricular drainage (EVD).
- Correlation of daily IL-6 (CSF) concentrations with clinical course and VRI incidence.
- VRI diagnosis based on classical criteria: cell count (CC), total protein (CSF), and clinical symptoms.
Main Results:
- VRI occurred in 26.7% of patients based on classical criteria.
- Significantly higher median IL-6 (CSF) levels (up to 2,000-fold increase) were observed one day before VRI diagnosis (p<0.001).
- A cut-off of IL-6 (CSF) ≥2,700 pg/ml showed a predictive value of 89%, sensitivity of 73.7%, and specificity of 91.4% for VRI.
Conclusions:
- IL-6 (CSF) is a reliable marker for predicting VRI in neurosurgical patients.
- IL-6 (CSF) enables earlier VRI detection than conventional diagnostic criteria.
- Early VRI prediction facilitates prompt initiation of treatment.
