Abstract
Background
To investigate whether sTREM-1, sIL-2Rα, sCD163, and IL-6 predict septic complications following polytrauma. Prospective observational study in a university hospital intensive care unit.
Methods
Blood samples were drawn on admission, 24 and 48 h after the injury from 64 adult polytrauma patients. The occurence of infectious complications was investigated. The sepsis-free rates for the multiple trauma patients were considered as end points in the Kaplan–Meier plot analysis.
Results
Upon admission, sIL-2Rα mean values were higher in the T group compared to the T&S patients (1789 ± 1027 pg/mL versus 1280 ± 605 pg/mL, p = 0.02). The initial mean values of sTREM-1, IL-6, and sCD163 did not discriminate between the T and T&S groups patients (p > 0.05). sTREM-1 cutoff was 62 pg/mL: the sepsis-free rates differed significantly between the patients with sTREM-1 concentrations lower and higher than the cutoff (80 versus 48 %, p < 0.01). From the patients with serum sIL-2Rα ≥1593 pg/mL, 86 % did not present sepsis; for sIL-2Rα values in the range 946–1593 pg/mL, the sepsis-free rate was 68 %, while from the patients with sIL-2Rα <945 pg/mL, only 40 % remained sepsis-free (p = 0.05). sCD163 cutoff of 1000 ng/mL did not discriminate between the patients (76 versus 64 %, p = 0.28). For IL-6, the sepsis-free rates differed significantly between the patients with concentrations lower and higher than 400 pg/mL (78 versus 38 %, p < 0.01).
Conclusions
sTREM-1, sIL-2Rα, and IL-6, but not CD163, may be used as prognostic markers for the occurrence of sepsis in multiple trauma patients.
Level of evidence
Level II-Diagnostic tests and criteria
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We thank Nicolae Todor for the statistical advice.
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This study was approved by the Ethics Committee of the “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania (Approval no. 549/2012), in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments and all included patients or their next of kin gave written informed consent.
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Sebastian Tranca, Jaap Ten Oever, Mihai Netea, Constantin Ciuce, Adriana Slavcovici, Cristina Petrisor, Natalia Hagau—declare that they have no conflict of interest.
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Trancă, S., Oever, J.T., Ciuce, C. et al. sTREM-1, sIL-2Rα, and IL-6, but not sCD163, might predict sepsis in polytrauma patients: a prospective cohort study. Eur J Trauma Emerg Surg 43, 363–370 (2017). https://doi.org/10.1007/s00068-016-0678-1
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DOI: https://doi.org/10.1007/s00068-016-0678-1