Abstract
BACKGROUND: To investigate whether sTREM-1, sIL-2Ralpha, 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-2Ralpha 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-2Ralpha >/=1593 pg/mL, 86 % did not present sepsis; for sIL-2Ralpha values in the range 946-1593 pg/mL, the sepsis-free rate was 68 %, while from the patients with sIL-2Ralpha <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-2Ralpha, 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.
