Plasma concentration of presepsin and its relationship to the diagnosis of infections in multiple trauma patients admitted to intensive care

Background and aims: Septic complications represent the predominant cause of late death in poly-trauma patients. The necessity to differentiate septic from non septic patients is more relevant at the early stage of the illness in order to improve the clinical outcome and to reduce the mortality. The identification of a sensitive and specific, clinically reliable, biomarker capable to early recognize incoming septic complications in trauma patients whose expression is not influenced by concomitant traumatic injuries, is still a challenge for the researchers in the field. Materials and methods: A retrospective analysis on 48 adult patients (9 females and 39 males, mean age 47.6±19 years) with multiple trauma was performed. The inclusion criterion was to suffer from acute trauma since no more than 24 hours and the exclusion criteria were the following: antibiotic treatment on admission and maintained for more than 48 hours; on-going infection on admission not associated with trauma; treatment with immunosuppressors/ immunomodulants; age <18 years old. Presepsin was measured using an automated chemiluminescence analyser at 1, 3, 5 and 8 days post of hospitalization. The diagnosis of systemic inflammatory response syndrome (SIRS)/infection was established according to the criteria of the Surviving Sepsis Campaign. Results and conclusions: In patients with SIRS, the mean presepsin concentration was 917,08 (±69.042) ng/L vs 980,258 (±1951.32) ng/L in patients without SIRS (P=0.769). In the infected patients, the mean presepsin concentration was 1513.25 (±2296.54) ng/L vs 654.21 (±511,068) ng/L (P<0.05) calculated among the non infected upon admission. The plasma presepsin concentration increased progressively during the first 8 days of hospitalization. Presepsin concentration in the infected patients was significantly higher than in non-infected patients. On the other hands no significant differences were found in the plasma level of presepsin among patients with and without SIRS. Any other clinical condition related to the trauma did not affect presepsin. Our data clearly suggest that presepsin may be considered an helpful diagnostic tool to early diagnose sepsis in trauma patients.

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Examining the relationship between the NUTRIC 2002 score and the complications and mortality up to 48 hours after the discharge of multiple trauma patients admitted to the ICU of Alzahra Hospital in Isfahan (2018-2019)

10.53350/pjmhs211561727 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1727-1731

Author(s):

Babak Ali Kiaii ◽

Seyed Taghi Hashemi ◽

Sara Mousavi ◽

NAFISEH SAFIAN

Keyword(s):

Eating Disorder ◽

Multiple Trauma ◽

Study Groups ◽

Trauma Patients ◽

Nutrition Risk ◽

Considerable Impact ◽

The Mean ◽

Multiple Trauma Patients ◽

Complications And Mortality ◽

The Relationship

Introduction: Eating disorders are among the most common problems in patients suffering from multiple trauma admitted to the ICU. They have a considerable impact on the increase of mortality risk. The present study aimed to determine the relationship between the Nutrition Risk in Critically ill (NUTRIC) score and the complications and mortality up to 48 hours after the discharge of multiple trauma patients admitted to the ICU of Alzahra Hospital in Isfahan between 2018 and 2019. Methodology: This study was descriptive-analytical research on 68 multiple trauma patients admitted to the ICU of Alzahra Hospital. The NUTRIC 2002 scores of the said patients were calculated by evaluating the parameters of age, APACHE II, SOFA Score, days in the hospital to ICU admission, and the number of comorbidities. Two different study groups were compared in terms of the said parameters, one composed of living and the other of deceased subjects. Findings: The mean NUTRIC 2002 Score was 3.5±0.03 in all studied patients. Out of the said patients, 67.6% and 32.4% of them were exposed to a low-risk eating disorder and a high-risk eating disorder, respectively. The mean of NUTRIC Scores in living and deceased patients were 2.82±3 and 1.19±5.83, respectively; which indicated that the deceased subjects had a higher NUTRIC Score (p<0.001). Conclusion: The 2002 NUTRIC Score was higher in the deceased subjects than in the living patients. Thus, this score seems to be a valuable and usable criterion for determining the eating disorder and the risk of mortality in multi-trauma patients admitted to the ICU. Keywords: NUTRIC, Multiple Trauma, Intensive Care, Death

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Have Severity Scores a Place in Predicting Septic Complications in ICU Multiple Trauma Patients?

The Journal of Critical Care Medicine ◽

10.1515/jccm-2016-0023 ◽

2016 ◽

Vol 2 (3) ◽

pp. 107-108

Author(s):

Daniela Ionescu

Keyword(s):

Multiple Trauma ◽

Trauma Patients ◽

Septic Complications ◽

Severity Scores ◽

Multiple Trauma Patients

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The Structure of Trauma Patients, its Management and Health Care in the University Hospital of Alexandroupolis

Folia Medica ◽

10.2478/folmed-2014-0008 ◽

2014 ◽

Vol 56 (1) ◽

pp. 50-55 ◽

Cited By ~ 3

Author(s):

Georgios V. Tsatsanidis ◽

Georgios I. Minopoulos ◽

Nicolaos D. Liratzopoulos ◽

Jannis V. Papathanasiou ◽

Konstantinos E. Simopoulos

Keyword(s):

Multiple Trauma ◽

Injury Severity ◽

Admission Rate ◽

Occupational Accidents ◽

Anatomical Location ◽

Trauma Patients ◽

Mechanism Of Injury ◽

Body Regions ◽

The Mean ◽

Multiple Trauma Patients

ABSTRACT OBJECTIVE: The present study was designed to describe the patterns of trauma patients using a newly-introduced trauma registry, as well as retrospectively assess the management and outcome facts of these patients. MATERIALS AND METHODS: The study included 2346 patients (62.15% male) with a mean age of 34.06 ± 23.77 years. Of these patients, 355 were multiple trauma patients. Privately owned vehicles were used as a mode of transportation for most of the trauma patients (96.65%). Data regarding patient demographics, arrival at the Emergency Department, mechanism of injury, injury severity, anatomical location and type of injury were collected and analyzed. RESULTS: Falls were the most prevalent mechanism of injury, accounting for 62.19% of the total admitted cases, with other causes (that also included occupational accidents and machinery trauma) being the second most prevalent, and MVAs - the third with a rate of 11.46%. The most commonly injured body regions were the extremities (50.26%), the head (42.50%), and the torso (19.39%). Fractures represented 11.46% of the injuries, while open wounds were much more frequent (29.41%). The mean abbreviated injury severity (AIS) score was 1.78 ± 1.48 for all admitted patients and 3.56 ± 1.02 for multiple trauma patients. A multi-disciplinary approach was required for 23% of the multiple trauma patients. The clinic admission rate for the whole patient sample was 13.55% and 48.96% for multiple trauma patients. The mean duration of stay for all clinic admissions was 2.7 days and 2.9 days for multiple trauma patients. CONCLUSIONS: With the epidemiology of trauma in Greece being rather poorly investigated, the present study manages to identify the major epidemiological patterns of trauma cases presenting to a tertiary regional hospital and addresses the need for development and implementation of injury prevention activities and policies

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Can APACHE II, SOFA, ISS, and RTS Severity Scores be Used to Predict Septic Complications in Multiple Trauma Patients?

The Journal of Critical Care Medicine ◽

10.1515/jccm-2016-0019 ◽

2016 ◽

Vol 2 (3) ◽

pp. 124-130 ◽

Cited By ~ 5

Author(s):

Sebastian Trancă ◽

Cristina Petrișor ◽

Natalia Hagău ◽

Constantin Ciuce

Keyword(s):

Multiple Trauma ◽

Infectious Complications ◽

Apache Ii ◽

Cutoff Score ◽

Trauma Patients ◽

Septic Complications ◽

Kaplan Meier ◽

Severity Scores ◽

Multiple Trauma Patients ◽

Composite Scores

Abstract Background: Physiological composite scores are used to predict mortality in multiple trauma patients. Sepsis is the leading cause of late mortality in trauma victims brought about by immune suppression due to homeostasis dysregulation. Objective: To determine whether APACHE II, SOFA, ISS and RTS scores can predict the occurrence of sepsis in multiple trauma patients. Methods: APACHE II, SOFA, ISS, and RTS scores were calculated during the first twenty-four hours after the injury for sixty-four adult poly-traumatic patients. The occurrence of infectious complications was investigated over a fourteenday period. The infection-free rates for the multiple trauma patients were considered as end-points in the Kaplan- Meier plot analysis. Results: For SOFA, a cutoff score of 4 points was identified as a predictor of the occurrence of sepsis, with 89% of the patients with SOFA<4 being infection-free, while 37% of those with SOFA>4 were infection-free (p<0.01). None of the patients with APACHE II≤5 points developed infections. Eighty-four percent of patients with APACHE II scores of 5-10 did not develop sepsis, while 49% with APACHE II≥11 were infection-free (p<0.01). A cutoff of 7 points was found to be most discriminative for RTS. Eighty-eight percent of the patients with RTS≥7 and 43% of those with RTS<7 were infection-free (p<0.01). Eighty-eight percent of patients with ISS<22 did not develop sepsis and 56% with ISS≥22 did not develop sepsis (p<0.01). Conclusion: APACHE II, SOFA, ISS, and RTS functional severity scores can predict mortality as well as the occurrence of sepsis in multiple trauma patients.

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