2021 Volume 67 Issue 2 Pages 158-164
Objective: As gastrointestinal tract perforation frequently causes severe sepsis, it is associated with a poor prognosis. We investigated the usefulness of measuring blood interleukin-6 (IL-6) levels using a simple semi-quantitative analysis kit to predict the severity of perforative peritonitis.
Materials and Methods: Nineteen patients with generalized peritonitis due to gastrointestinal tract perforation who had undergone surgery in our department were eligible for this study. Preoperative blood IL-6 levels were measured using a semi-quantitative analysis kit and classified into two groups according to the color code: a dark-colored group (IL-6 ≥5,000 pg/ml) and a light-colored group (IL-6 <5,000 pg/ml). The two groups were then compared in terms of preoperative inflammatory markers, severity scores (Mannheim Peritonitis Index (MPI), Acute Physiology and Chronic Health Evaluation (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score), postoperative factors, and outcome (survive/death).
Results: The median age of the patients was 70 years. The median interval between the onset of symptoms and surgery was 13 hours. Seventeen patients survived, and 2 patients died. Compared with the light-colored group, the preoperative white blood cell count was significantly lower; however, the MPI, postoperative SOFA score, and number of patients requiring vasopressors and hemoperfusion using polymyxin B-immobilized fiber column after surgery were significantly higher in the dark-colored group. Perforative peritonitis in the dark-colored group was more often associated with a fatal outcome (p=0.04).
Conclusion: The results suggest that the semi-quantification of blood IL-6 levels is useful for predicting the outcome of patients with generalized peritonitis due to gastrointestinal tract perforation.