Serum CRP and IL-6 levels after trauma. Not predictive of septic complications in 31 patients.
We studied 31 blunt trauma victims, Injury Severity Score (ISS) mean 14 (9-57), for the pattern of release of C-reactive protein (CRP) and cytokine interleukin-6 (IL-6). Blood samples were taken on admission (within 6 hours of injury), as well as at 24 hours, and 3, 5 and 7 days. Serum CRP and IL-6 were measured by ELISA. Subsequent surgical events and sepsis were noted. Serum IL-6 levels on admission were considerably higher (median 135 pg mL-1) than our laboratory reference range (< 5 pg mL-1), slowly returning towards reference values during the study. Serum CRP levels were similar to laboratory normal values on admission (median 8.5 mg L-1 vs 7.5 mg L-1), reaching peak values (median 110 mg L-1) after 3 days. There was a correlation between IL-6 release and ISS but not between CRP and ISS. Patients undergoing surgery showed further increases in IL-6 and CRP levels postoperatively. Of 24 surgical patients, 9 developed postoperative sepsis. In blunt trauma patients, early assessment of the markers CRP or IL-6 were not useful for the diagnosis of sepsis. Levels of CRP following accidental or surgical trauma should be assessed with caution.
Giannoudis
P V
PV
Department of Trauma, St. James's University Hospital, Leeds, U.K.
Smith
M R
MR
Evans
R T
RT
Bellamy
M C
MC
Guillou
P J
PJ
D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D005264:Femoral Fractures / Q000097:blood; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D015601:Injury Severity Score; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012016:Reference Values; D018805:Sepsis / Q000097:blood*; D014949:Wounds, Nonpenetrating / Q000097:blood* / Q000601:surgery
D015850:Interleukin-6; D002097:C-Reactive Protein