- The practicality of interleukin-6 in prognosis of blunt chest trauma in Korea: a retrospective study
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Jeong Woo Oh, Tae Yeon Lee, Minjeong Chae
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J Trauma Inj. 2023;36(2):114-120. Published online December 8, 2022
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DOI: https://doi.org/10.20408/jti.2022.0050
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 Abstract
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- 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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Summary
- Clinical implications of the newly defined concept of ventilator-associated events in trauma patients
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Tae Yeon Lee, Jeong Woo Oh, Min Koo Lee, Joong Suck Kim, Jeong Eun Sohn, Jeong Hwan Wi
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J Trauma Inj. 2022;35(2):76-83. Published online December 24, 2021
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DOI: https://doi.org/10.20408/jti.2021.0064
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Abstract
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- Purpose
Ventilator-associated pneumonia is the most common nosocomial infection in patients with mechanical ventilation. In 2013, the new concept of ventilator- associated events (VAEs) replaced the traditional concept of ventilator-associated pneumonia. We analyzed risk factors for VAE occurrence and in-hospital mortality in trauma patients who received mechanical ventilatory support.
Methods
In this retrospective review, the study population comprised patients admitted to the Jeju Regional Trauma Center from January 2020 to January 2021. Data on demographics, injury characteristics, and clinical findings were collected from medical records. The subjects were categorized into VAE and no-VAE groups according to the Centers for Disease Control and Prevention/National Healthcare Safety Network VAE criteria. We identified risk factors for VAE occurrence and in-hospital mortality.
Results
Among 491 trauma patients admitted to the trauma center, 73 patients who received ventilator care were analyzed. Patients with a chest Abbreviated Injury Scale (AIS) score ≥3 had a 4.7-fold higher VAE rate (odds ratio [OR], 4.73; 95% confidence interval [CI], 1.46–17.9), and those with a glomerular filtration rate (GFR) <75 mL/min/1.73 m2 had 4.1-fold higher odds of VAE occurrence (OR, 4.15; 95% CI, 1.32–14.1) and a nearly 4.2-fold higher risk for in-hospital mortality (OR, 4.19; 95% CI, 1.30–14.3). The median VAE-free duration of patients with chest AIS ≥3 was significantly shorter than that of patients with chest AIS <3 (P=0.013).
Conclusions
Trauma patients with chest AIS ≥3 or GFR <75 mL/min/1.73 m2 on admission should be intensively monitored to detect at-risk patients for VAEs and modify the care plan accordingly. VAEs should be closely monitored to identify infections early and to achieve desirable results. We should also actively consider modalities to shorten mechanical ventilation in patients with chest AIS ≥3 to reduce VAE occurrence.
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