title: The relationship of trauma severity and mortality with cardiac enzymes and cytokines at multiple trauma patients.
abstract: BACKGROUND
  In this study, we aimed to determine the effects of trauma severity on cardiac involvement through evaluating the trauma severity score together with diagnostic tests in multiple trauma patients. A trauma score was determined using various trauma severity scales.
  
  
  METHODS
  After obtaining the approval of the ethics committee of the faculty, this prospective study was performed through evaluating 100 multiple trauma patients, aged over 15 years, who applied to our Emergency Department (ED). After determining the trauma severity score using instruments such as the Injury Severity Score (ISS), Glasgow Coma Scale (GCS), and Revised Trauma Score (RTS), the cardiac condition was evaluated using biochemical and radiological diagnostic tests.
  
  
  RESULTS
  During the study period, 100 patients were evaluated (78 male, 22 female; mean age: 33.2±15.4; range 15 to 70 years). It was determined that 92 (92%) were blunt trauma cases, and 77 (77%) of them were due to traffic accidents. The majority of cases showed electrocardiogram (ECG) abnormalities (63%) and sinus tachycardia (36%). Abnormal echocardiogram (ECHO) findings, mostly accompanied by ventricular defects (n=24), were determined in 31 of the cases. Nineteen cases with high trauma severity score resulted in death, and 14 of all deaths were secondary to traffic accidents. Trauma scores were found to show a significant difference between the two groups.
  
  
  CONCLUSIONS
  The ISS trauma scale was determined to be the most effective in terms of indicating heart involvement in patients with multiple traumas. Close follow-up and cardiac monitoring should be applied to patients with high trauma severity scores considering possible cardiac rhythm changes and hemodynamic disturbances due to cardiac involvement.
authors.affiliation: Department of Emergency Medicine, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey. drkarakus@yahoo.com
authors.forename: Ali
authors.initials: A
authors.lastname: Karakuş
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Kekeç
authors.forename: Ramazan
authors.initials: R
authors.lastname: Akçan
authors.forename: Gülşah
authors.initials: G
authors.lastname: Seydaoğlu
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications; D052279:Creatine Kinase, MB Form / Q000032:analysis; D016207:Cytokines / Q000378:metabolism*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D015600:Glasgow Coma Scale; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis / Q000201:enzymology / Q000276:immunology; D006439:Hemodynamics; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000201:enzymology / Q000276:immunology / Q000401:mortality / Q000503:physiopathology*; D015599:Trauma Severity Indices; D020107:Troponin T / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D055986:Vital Signs; D014949:Wounds, Nonpenetrating / Q000201:enzymology / Q000276:immunology / Q000401:mortality / Q000503:physiopathology; D055815:Young Adult
chemical_list: D016207:Cytokines; D020107:Troponin T; D014409:Tumor Necrosis Factor-alpha; D052279:Creatine Kinase, MB Form