title: Differential expression of the immunoinflammatory response in trauma patients: burn vs. non-burn.
abstract: BACKGROUND
  Cytokines are central mediators of the immune-inflammatory response to injury and subsequent multiple organ dysfunction syndrome (MODS). Although previous studies evaluated cytokine levels after trauma, differences between patients with burn and non-burn trauma have not been assessed systematically.
  
  
  METHODS
  A prospective database of trauma patients admitted between May 2004 and September 2007 to the burn or surgical intensive care units within 24 h of injury with an anticipated stay of at least 72 h was analyzed. Sequential clinical and laboratory parameters were collected in the first week, including multiplex analysis data for plasma levels of inflammatory cytokines (IL-6, and IL-8). Patients with known pre-injury coagulopathy were excluded. A Marshall score of 10 or greater was defined as MODS.
  
  
  RESULTS
  A total of 179 patients were enrolled (67 burn and 112 non-burn). Plasma IL-6 and IL-8 levels were markedly elevated in both burn and non-burn patients compared to healthy volunteers. Burn subjects had higher levels of IL-6 and IL-8 than the non-burn on days 1 through 7 after injury. Subjects with burns and at least 30% total body surface area were older and had a lower injury severity score, a higher prevalence of MODS, and correspondingly higher mortality. Multivariate analysis of injury type, MODS, and time did not demonstrate an influence of MODS.
  
  
  CONCLUSIONS
  Burns were associated with a greater and more sustained immune-inflammatory response than non-burn trauma as evidenced by elevated plasma IL-6 and IL-8 levels during the first week. There was no association between MODS and plasma cytokine levels.
authors: U.S. Army Institute of Surgical Research, Fort Sam Houston, TX 78234, USA.
authors: James E
authors: JE
authors: Mace
authors: Myung S
authors: MS
authors: Park
authors: Alejandra G
authors: AG
authors: Mora
authors: Kevin K
authors: KK
authors: Chung
authors: Wenjun
authors: W
authors: Martini
authors: Christopher E
authors: CE
authors: White
authors: John B
authors: JB
authors: Holcomb
authors: Gerald A
authors: GA
authors: Merrill
authors: Michael A
authors: MA
authors: Dubick
authors: Steven E
authors: SE
authors: Wolf
authors: Charles E
authors: CE
authors: Wade
authors: Martin G
authors: MG
authors: Schwacha
mesh_terms: D000328:Adult; D002056:Burns / Q000150:complications / Q000276:immunology*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D016209:Interleukin-8 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000276:immunology; D015999:Multivariate Analysis; D011446:Prospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology*; D014947:Wounds and Injuries / Q000276:immunology*
chemical_list: D015850:Interleukin-6; D016209:Interleukin-8