Journal of Trauma and Injury

  • 제36권2호
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  • Pages.114-120
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  • 2023
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  • 2799-4317(pISSN)
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  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
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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
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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.

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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.