DOI QR코드

DOI QR Code

The practicality of interleukin-6 in prognosis of blunt chest trauma in Korea: a retrospective study

  • Jeong Woo Oh (Department of Trauma Surgery, Trauma Center, Cheju Halla General Hospital) ;
  • Tae Yeon Lee (Department of Trauma Surgery, Trauma Center, Ulsan University Hospital) ;
  • Minjeong Chae (Department of Nursing, Chosun Nursing College)
  • 투고 : 2022.09.05
  • 심사 : 2022.11.12
  • 발행 : 2023.06.30

초록

Purpose: There are many studies on the practicality of interleukin-6 (IL-6) as a prognostic predictor in patients with multiple severe traumas. However, few studies focus on the practicality of IL-6 in patients with chest trauma. So, this study investigated whether IL-6 is effective as a prognostic factor in patients with blunt chest trauma. Methods: A total of 44 blunt chest trauma patients who visited the regional trauma center from July to December 2021 were included in this retrospective study. Blood IL-6 levels were measured immediately after emergency room admittance (IL-6 E) and 24 hours after trauma (IL-6 24). To determine whether IL-6 levels can predict the clinical course and prognosis of patients with blunt chest trauma, the correlation between IL-6 (IL-6 E and IL-6 24) and the trauma score system, Injury Severity Score, Thoracic Trauma Severity Score, and Pulmonary Contusion Score, intensive care unit (ICU) stay period, and total hospitalization period were analyzed. Results: IL-6 E showed a good correlation with Injury Severity Score (P=0.505), Thoracic Trauma Severity Score (P=0.597), Pulmonary Contusion Score (P=0.493), ICU stay period (P=0.762), and total hospitalization period (P=0.662). However, IL-6 24 had a relatively low correlation compared to IL-6 E. Therefore, IL-6 E showed useful results for predicting the prognosis of patients with blunt chest trauma. Conclusions: Early plasma IL-6 levels (IL-6 E) can predict the injury severity of blunt chest trauma, length of ICU stay, and total hospitalization period.

키워드

참고문헌

  1. Hoke MH, Usul E, Ozkan S. Comparison of trauma severity scores (ISS, NISS, RTS, BIG score, and TRISS) in multiple trauma patients. J Trauma Nurs 2021;28:100-6.  https://doi.org/10.1097/JTN.0000000000000567
  2. Orhon R, Eren SH, Karadayi S, et al. Comparison of trauma scores for predicting mortality and morbidity on trauma patients. Ulus Travma Acil Cerrahi Derg 2014;20:258-64.  https://doi.org/10.5505/tjtes.2014.22725
  3. Lord JM, Midwinter MJ, Chen YF, et al. The systemic immune response to trauma: an overview of pathophysiology and treatment. Lancet 2014;384:1455-65.  https://doi.org/10.1016/S0140-6736(14)60687-5
  4. Laupland KB, Kirkpatrick AW, Kortbeek JB, Zuege DJ. Long-term mortality outcome associated with prolonged admission to the ICU. Chest 2006;129:954-9.  https://doi.org/10.1378/chest.129.4.954
  5. Ulvik A, Kvale R, Wentzel-Larsen T, Flaatten H. Multiple organ failure after trauma affects even long-term survival and functional status. Crit Care 2007;11:R95. 
  6. Llompart-Pou JA, Talayero M, Homar J, Royo C; Grupo de trabajo de Trauma y Neurointensivismo de SEMICYUC. Multiorgan failure in the serious trauma patient. Med Intensiva 2014;38:455-62.  https://doi.org/10.1016/j.medin.2014.05.004
  7. Dewar DC, Tarrant SM, King KL, Balogh ZJ. Changes in the epidemiology and prediction of multiple-organ failure after injury. J Trauma Acute Care Surg 2013;74:774-9.  https://doi.org/10.1097/TA.0b013e31827a6e69
  8. Volpin G, Cohen M, Assaf M, Meir T, Katz R, Pollack S. Cytokine levels (IL-4, IL-6, IL-8 and TGFβ) as potential biomarkers of systemic inflammatory response in trauma patients. Int Orthop 2014;38:1303-9.  https://doi.org/10.1007/s00264-013-2261-2
  9. Qiao Z, Wang W, Yin L, et al. Using IL-6 concentrations in the first 24 h following trauma to predict immunological complications and mortality in trauma patients: a meta-analysis. Eur J Trauma Emerg Surg 2018;44:679-87.  https://doi.org/10.1007/s00068-017-0880-9
  10. Gebhard F, Pfetsch H, Steinbach G, Strecker W, Kinzl L, Bruckner UB. Is interleukin 6 an early marker of injury severity following major trauma in humans? Arch Surg 2000;135:291-5.  https://doi.org/10.1001/archsurg.135.3.291
  11. Dogrul BN, Kiliccalan I, Asci ES, Peker SC. Blunt trauma related chest wall and pulmonary injuries: an overview. Chin J Traumatol 2020;23:125-38.  https://doi.org/10.1016/j.cjtee.2020.04.003
  12. Taniguchi M, Nakada TA, Shinozaki K, Mizushima Y, Matsuoka T. Association between increased blood interleukin-6 levels on emergency department arrival and prolonged length of intensive care unit stay for blunt trauma. World J Emerg Surg 2016;11:6. 
  13. Kurt A, Turut H, Acipayam A, et al. Investigation of surfactant protein-D and interleukin-6 levels in patients with blunt chest trauma with multiple rib fractures and pulmonary contusions: a cross-sectional study in Black Sea Region of Turkey. BMJ Open 2016;6:e011797. 
  14. Kim JJ, Shin JH, Jin W, et al. The value of grading of pulmonary contusion by the chest CT scanning. J Korean Soc Emerg Med 2004;15:452-5. 
  15. Pape HC, Remmers D, Rice J, Ebisch M, Krettek C, Tscherne H. Appraisal of early evaluation of blunt chest trauma: development of a standardized scoring system for initial clinical decision making. J Trauma 2000;49:496-504.  https://doi.org/10.1097/00005373-200009000-00018
  16. Stensballe J, Christiansen M, Tonnesen E, Espersen K, Lippert FK, Rasmussen LS. The early IL-6 and IL-10 response in trauma is correlated with injury severity and mortality. Acta Anaesthesiol Scand 2009;53:515-21.  https://doi.org/10.1111/j.1399-6576.2008.01801.x
  17. Jastrow KM 3rd, Gonzalez EA, McGuire MF, et al. Early cytokine production risk stratifies trauma patients for multiple organ failure. J Am Coll Surg 2009;209:320-31.  https://doi.org/10.1016/j.jamcollsurg.2009.05.002
  18. Cuschieri J, Bulger E, Schaeffer V, et al. Early elevation in random plasma IL-6 after severe injury is associated with development of organ failure. Shock 2010;34:346-51.  https://doi.org/10.1097/SHK.0b013e3181d8e687
  19. Frink M, van Griensven M, Kobbe P, et al. IL-6 predicts organ dysfunction and mortality in patients with multiple injuries. Scand J Trauma Resusc Emerg Med 2009;17:49. 
  20. Jeju Regional Trauma Center. Annual report of Jeju Regional Trauma Center, 2021. Hyuck Jin; 2022.