High concentrations of circulating macrophage migration inhibitory factor in patients with severe blunt trauma: Is serum macrophage migration inhibitory factor concentration a valuable prognostic factor?
OBJECTIVE
To determine serum concentrations of macrophage migration inhibitory factor and other cytokines in severe blunt trauma patients in critical settings and to evaluate their association with patient outcome.


METHODS
Prospective, observational study.


METHODS
Emergency department and surgical intensive care unit of a university hospital.


METHODS
Fifty-four severe blunt trauma patients with systemic inflammatory response syndrome requiring intensive care, emergency surgical intervention, or both were enrolled in the study. Forty-four patients with minor injuries were the controls.


METHODS
Serum macrophage migration inhibitory factor concentrations were measured in the emergency department <4 hrs postinjury (day 1) and the surgical intensive care unit 24 hrs later (day 2). Blood samples for determination of tumor necrosis factor-alpha, interleukin-6, interleukin-8, and interleukin-10 were measured both in patients with severe blunt trauma and in controls. The Acute Physiology and Chronic Health Evaluation II, Injury Severity Score, Revised Trauma Score, and Trauma Revised Injury Severity Score were used for clinical evaluation of trauma severity.


RESULTS
Serum macrophage migration inhibitory factor concentrations were higher in severe blunt trauma patients than in controls; were significantly correlated with Acute Physiology and Chronic Health Evaluation II, Revised Trauma Score, and Trauma Revised Injury Severity Score scores in severe blunt trauma patients but not in controls; and were higher in nonsurvivors than in survivors.


CONCLUSIONS
Our data suggest that the serum macrophage migration inhibitory factor concentration is higher in severe blunt trauma and that it reflects the severity of trauma. The serum macrophage migration inhibitory factor concentration might be a valuable predictor for the outcome of severe blunt trauma.
Chuang
Chia-Chang
CC
Department of Emergency Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Hung
Chung-Jye
CJ
Tsai
Ming-Che
MC
Yeh
Tria-Ming
TM
Chuang
Yin-Ching
YC
D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019370:Observation; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D013624:Taiwan / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000097:blood* / Q000175:diagnosis / Q000401:mortality
D015415:Biomarkers; D008263:Macrophage Migration-Inhibitory Factors