Biochemical Markers with Predictive Value in Polytrauma Patients with Femoral Fractures

Abstract

Polytrauma represents one of the most challenging aspects of modern medicine, due to its high mortality and morbidity, affecting especially young, active patients. Therefore, research is nowadays directed towards optimising the treatment for these patients, which is extremely difficult, as polytrauma is characterized by a complicated pathophysiology with intricate pathways, potentially generating local and general complications and requiring a multidisciplinary approach. An essential issue for these patients is a careful monitoring algorithm, able to determine an appropriate therapeutic response in due time, so objective, measurable and reproducible elements able to do this have been sought. Since biochemical markers have these properties, and the most important pathogenic element in polytrauma is the Systemic Inflammatory Response Syndrome (SIRS), the authors of this paper evaluate the predictive value of inflammatory markers in order to improve the monitoring algorithm of these patients. The results of this prospective study demonstrate some statistically significant correlations, such as those between lactate (at admission and 24 hours later) and mortality, as well as between IL-6 and early systemic complications, which are of great value because they can concentrate the efforts of the multidisciplinary team and save the life of the poytrauma patient.

Preoperative Hemoglobin Dynamics in Patients with Trochanteric Fractures. A multivariate analysis

“…Numerous studies identified a correlation between the presence of anemia, increased mortality and diminishing postoperative functional outcomes in patients with proximal femoral fractures [3,4,13,14]. Identifying the ideal operator time from the perspective of limiting preoperative blood loss should be a constant concern to ensure therapeutic success for patients with trochanteric fractures.…”