Citation

Frink M, van Griensven M, Kobbe P, Brin T, Zeckey C, Vaske B, Krettek C, Hildebrand F. Scand. J. Trauma Resusc. Emerg. Med. 2009; 17(1): 49.

Copyright

(Copyright © 2009, Scandinavian Networking Group on Trauma and Emergency Management, Publisher Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/1757-7241-17-49

PMID

19781105

PMCID

PMC2763001

Abstract

BACKGROUND: Although therapeutic concepts of patients with major trauma have improved during recent years, organ dysfunction still remains a frequent complication during clinical course in intensive care units. It has previously been shown that cytokines are upregulated under stress conditions such as trauma or sepsis. However, it is still debatable if cytokines are adequate parameters to describe the current state of trauma patients. To elucidate the relevance of cytokines, we investigated if cytokines predict development of multiple organ dysfunction syndrome (MODS) or outcome. METHODS: A total of 143 patients with an injury severity score > 16, between 16 and 65 years, admitted to the Hannover Medical School Level 1 Trauma Center between January 1997 and December 2001 were included in this study. Marshall Score for MODS was calculated for at least 14 days and plasma levels of TNF-alpha, IL-1beta, IL-6, IL-8 and IL-10 were measured. To determine the association between cytokine levels and development of MODS the Spearman rank correlation coefficient was calculated and logistic regression and analysis were performed. Results and Discussion: Patients with MODS had increased plasma levels of IL-6, IL-8 and IL-10. IL-6 predicteded development of MODS with an overall accuracy of 84.7% (sensitivity: 98.3%, specificity: 16.7%). The threshold value for development of MODS was 761.7 pg/ml and 2176.0 pg/ml for mortality. CONCLUSIONS: We conclude that plasma IL-6 levels predict mortality and that they are a useful tool to identify patients who are at risk for development of MODS.

Language: en