Systemic Inflammation: Methodological Approaches to Identification of the Common Pathological Process

Area of Science:

• Pathology
• Biochemistry
• Clinical Medicine

Background:

• Systemic inflammation (SI) is a complex pathological process involving widespread inflammatory responses.
• Accurate identification of SI is crucial for patient management and outcome prediction.
• Existing methods for assessing SI may not fully capture its systemic nature.

Purpose of the Study:

• To develop and validate methodological approaches for identifying Systemic Inflammation (SI).
• To establish reliable scales for quantifying the probability and severity of SI.
• To assess the predictive value of these scales for patient outcomes.

Main Methods:

• Development of two scales: Reactivity Level (RL) scale (0-5 points) and Systemic Inflammation (SI) scale.
• RL scale measures plasma concentrations of IL-6, IL-8, IL-10, TNF-α, and C-reactive protein.
• SI scale incorporates RL with additional criteria: D-dimers, cortisol, troponin I, and myoglobin levels.

Main Results:

• The study included 422 patients with septic (n=207) and aseptic (n=215) pathologies.
• SI was identified in 190 cases (45%), with a lethality rate of 38.4%.
• SI was present in 100% of septic shock cases (n=31) and showed comparable predictive accuracy for mortality to SOFA score in sepsis and trauma.

Conclusions:

• The developed RL and SI scales provide a robust method for identifying Systemic Inflammation.
• These scales demonstrate significant potential in predicting patient outcomes, including lethality.
• The findings support the utility of these scales in clinical practice for managing patients with critical illnesses.