The prognostic importance of serum IL-1beta, IL-6, IL-8 and TNF-alpha levels compared to trauma scoring systems for early mortality in children with blunt trauma.
The purpose of the present study was to determine whether a correlation exits between the main trauma scoring systems and the activation of inflammatory cells and mediators such as interleukin-(IL-) 1beta, IL-6, IL-8 and tumor necrosis factor alpha (TNF-alpha) after trauma, and moreover to assess if any of these can be used to predict the outcome in patients under care at a trauma center. Forty-seven children (37 boys, 10 girls) presenting with blunt trauma, were evaluated by an analysis of the relationship between overall mortality and potential risk factors. Admission data, including serum IL-1beta, IL-6, IL-8, TNF-alpha, pediatric trauma score (PTS), and injury severity score (ISS), were collected and analyzed. In descriptive statistics for independent variables, some prognostic factors such as IL-8 (P = 0.04), and ISS (P = 0.004) were significant in their relationship to mortality. In the univariate statistical analysis some other risk factors such as IL-8 (P = 0.004), >20 TNF-alpha (P = 0.04), and ISS (P = 0.007) were significant in their relationship to mortality. The relative risk of developing mortality was higher than two for each of the following risk factors: >10 ages, >25 IL-6, 10-20 TNF-alpha, >20 TNF-alpha, PTS <or= 8, and ISS > 15. There was a positive correlation between IL-8 (r = 0.31, P = 0.33), ISS (r = 0.31, P = 0.0001), and mortality. There was also a correlation with ISS and IL-8 (r = 0.32, P = 0.02). ISS, and the serum IL-8 level are the most important determinants of clinical outcome in critically injured patients. A correlation exits between IL-8 and mortality and between ISS and IL-8.
Department of Pediatric Surgery, Medical School, Abant Izzet Baysal University, 14280 Bolu, Turkey. ozturkhayrettin@hotmail.com
Hayrettin
H
Ozturk
Yusuf
Y
Yagmur
Hulya
H
Ozturk
D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015599:Trauma Severity Indices; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014949:Wounds, Nonpenetrating / Q000097:blood* / Q000401:mortality*
D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha