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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

, 17:49

First Online: 27 September 2009Received: 14 May 2009Accepted: 27 September 2009

Abstract

BackgroundAlthough 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.

MethodsA 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 prospectively included in this study. Marshall Score for MODS was calculated for at least 14 days and plasma levels of TNF-α, IL-1β, 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 DiscussionPatients with MODS had increased plasma levels of IL-6, IL-8 and IL-10. IL-6 predicted development of MODS with an overall accuracy of 84.7% specificity: 98.3%, sensitivity: 16.7%. The threshold value for development of MODS was 761.7 pg-ml and 2176.0 pg-ml for mortality during the in patient time.

ConclusionWe 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.

List of abbrevationsARDSadult respiratory distress syndrome

CRPC-reactive protein

ILinterleukin

ISSinjury severity score

mlmillilitre

MOFmulti organ failure

MODSmulti organ dysfunction syndrome

pgpicograme

TNFtumor necrosis factor

Electronic supplementary materialThe online version of this article doi:10.1186-1757-7241-17-49 contains supplementary material, which is available to authorized users.

Michael Frink, Martijn van Griensven, Philipp Kobbe, Thomas Brin, Christian Zeckey, Bernhard Vaske, Christian Krettek and Frank Hildebrand contributed equally to this work.

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Autor: Michael Frink - Martijn van Griensven - Philipp Kobbe - Thomas Brin - Christian Zeckey - Bernhard Vaske - Christian Krettek

Fuente: https://link.springer.com/







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