Interleukin-6 and C-reactive protein serum levels in sepsis-related fatalities during the early postmortem period

Forensic Sci Int. 2001 Jun 1;119(1):47-56. doi: 10.1016/s0379-0738(00)00391-1.

Abstract

Postmortem interleukin-6 (IL-6) and C-reactive protein (CRP) serum levels were investigated prospectively in sepsis-related fatalities and non-septic fatalities by using a linear regression model. At least three blood samples were collected between 0.3 and 139 h postmortem from sepsis-related fatalities (n=8) and non-septic fatalities (n=16). In addition, one antemortem blood sample was collected shortly before death from the septic patients. Antemortem and postmortem IL-6 and CRP levels were highly elevated in all individuals included in the sepsis group. An excessive postmortem increase of IL-6 serum levels associated with progressive time after death was observed in five out of the eight septic patients. Both, IL-6 and CRP serum concentrations seem to be suitable biochemical postmortem markers of sepsis. The determination of IL-6 serum levels above 1500 pg/ml in peripheral venous blood obtained in the early postmortem interval can be considered as a diagnostic hint towards an underlying septic condition. A more precise postmortem discrimination between sepsis and non-septic underlying causes of death is provided by the postmortem measurement of serum CRP in peripheral venous blood: on condition that at least two postmortem CRP values have been determined at different time points postmortem, the CRP level of a deceased at the time of death can be calculated by using linear regression analysis. When assessing postmortem IL-6 and CRP concentrations as biochemical postmortem markers of sepsis, various clinical conditions, such as a preceding trauma or burn injury going along with elevated IL-6 and/or CRP levels prior to death as a result of the systemic inflammatory response syndrome (SIRS) should be taken into consideration, thus adding relevant information for the practical interpretation of the results.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Autopsy / methods*
  • Autopsy / standards
  • Biomarkers / blood
  • C-Reactive Protein / immunology
  • C-Reactive Protein / metabolism*
  • Case-Control Studies
  • Cause of Death
  • Discriminant Analysis
  • Female
  • Humans
  • Interleukin-6 / blood*
  • Interleukin-6 / immunology
  • Linear Models
  • Male
  • Middle Aged
  • Postmortem Changes*
  • Prospective Studies
  • Sepsis / blood*
  • Sepsis / immunology
  • Sepsis / mortality
  • Time Factors

Substances

  • Biomarkers
  • Interleukin-6
  • C-Reactive Protein