Systemic inflammatory response syndrome score at admission predicts injury severity, organ damage and serum neutrophil elastase production in trauma patients.
BACKGROUND
Systemic inflammatory response syndrome (SIRS) is a clinical condition representing the culmination of the activation of a complex network of acute endogenous mediators.


METHODS
We investigated both the relationship between the results of SIRS assessments in 212 trauma patients at the time of hospital arrival and measures of trauma severity determined using the Injury Severity Score (ISS) and the Revised Trauma Score (RTS). We then considered the possibility of whether this assessment could be used to predict the development of organ dysfunction as a complication in trauma patients after admission. The serum neutrophil elastase (SNE) level was also measured in 47 cases.


RESULTS
The cases with SIRS had a significantly higher ISS and a lower RTS. Organ dysfunction occurred in 22 cases, and a significant correlation was noted between the development of organ dysfunction and the presence of SIRS (86.4%; 19 cases/22 cases, p=0.0007) at the time of arrival. The SNE level was significantly higher among the patients who fulfilled the four SIRS criteria than among the other patients (p=0.0301).


CONCLUSIONS
We concluded that the greater the SIRS score at the time of hospital arrival, the greater the anatomical and physiological severity of the trauma patient's condition.
Sakamoto
Yuichiro
Y
Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, Japan. y-sakamoto@mms.ac.jp
Mashiko
Kunihiro
K
Matsumoto
Hisashi
H
Hara
Yoshiaki
Y
Kutsukata
Noriyoshi
N
Yokota
Hiroyuki
H
D000368:Aged; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D019272:Leukocyte Elastase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D015995:Prevalence; D012189:Retrospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis*
D019272:Leukocyte Elastase