Admission level of Gc-globulin predicts outcome after multiple trauma.
BACKGROUND
Actin is the dominating protein in mammalian cells. Release of excessive amounts of actin into the circulation may result in a condition resembling multiple organ failure. The purpose of this study was to determine if admission levels of Gc-globulin can predict survival after multiple trauma. Also, we wanted to compare the predictive ability of Gc-globulin with that of the TRISS-Like scoring system.


METHODS
Fifty-seven patients with a median ISS 18 (16-75) were included. All patients had a blood sample taken median 42 min after the injury (19-110 min). Serum Gc-globulin was measured by rocket immunoelectrophoresis.


RESULTS
On admission, all patients had significantly reduced levels of Gc-globulin compared with normal controls. Gc-globulin was significantly higher in the group of survivors (n = 41), compared with non-survivors (n = 16). Median 237 mg/l vs. 188 mg/l (P < 0.01). The predictive ability of Gc-globulin regarding death was similar to that of TRISS-Like with positive predictive values of 69%, a negative predictive value of 84%, a sensitivity of 56% and a specificity of 90%.


CONCLUSIONS
The predictive value of Gc-globulin regarding survival was similar to that of an established scoring system. Gc-globulin, alone or in combination with other parameters, may serve as a routine tool for early identification of patients at risk after severe injury, increasing the possibility of early intervention.
Dahl
B
B
Department of General Surgery, University of Texas Southwestern Medical Center at Dallas 75235-9031, USA.
Schiødt
F V
FV
Nielsen
M
M
Kiaer
T
T
Williams
J G
JG
Ott
P
P
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D015996:Survival Rate; D015599:Trauma Severity Indices; D014809:Vitamin D-Binding Protein / Q000097:blood*
D015415:Biomarkers; D014809:Vitamin D-Binding Protein