Serum interleukin-6 level as an early marker of injury severity in trauma patients in an urban low-income setting: a cross-sectional study

Abstract

BackgroundTrauma is still the leading cause of death in many regions of the world. Severity scores have been developed to assist in management of trauma victims. Immune response to trauma has been known to positively correspond to the severity of trauma. Part of this response involves release of cytokines into blood circulation which promote the acute inflammatory response commonly seen after trauma. Studies have shown that IL-6 levels commonly correlate positively with the Injury Severity Score (ISS). The aim of this cross-sectional study was to determine whether this kind of relationship exists between IL-6 levels and injury severity in trauma patients in Mulago Hospital as defined by the Kampala Trauma Score (KTSII) which is locally developed.MethodsTrauma patients aged ≥18 years presenting to the Accident and Emergency unit of Mulago National Referral Hospital (MNRH) within 12 h after injury were recruited into the study after obtaining consent. Severity of injury was determined as per the Kampala Trauma Score (KTSII) and venous blood drawn for assay of serum IL-6 levels. Data obtained was entered and analyzed using Stata version 11 software focusing on the association between Serum IL-6 levels with Severity of trauma and duration of injury.ResultsA total of 159 patients were recruited (79 Mild and 80 Severe trauma) with a male to female ratio of 4.7:1. Road traffic crashes (67.92 %) were the commonest cause of injury. Serum IL-6 levels were found to positively correspond with severity of injury (z = 4.718, p < 0.001). There was no significant correlation between serum IL-6 levels and duration of injury in both severe (r = 0.12, p = 0.29) and mild (r = 0.06, p = 0.62) trauma groups of patients. Only 9.43 % of trauma patients were brought in an Ambulance.ConclusionsSerum IL-6 levels correspond with severity of injury. However, within the first twelve hours after injury, these levels did not vary significantly with duration of injury.

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

“…However, the measurement performed after these hours to be clinically insignificant. 38 There was a significant relation between the development of complications and 6-hour SP-D level in this study. Hospitalisation costs and duration of the patient who developed complications were increased.…”

A conceptual time window‐based model for the early stratification of trauma patients

“…IL‐6, for example, which is perhaps the most well‐studied biomarker of trauma, is a pro‐inflammatory mediator which acts as a procoagulant , results in the release of acute phase reactants such as C‐reactive protein , causes a shift in chemokine production and induces proliferation of B and T cells . In terms of its use as a prognosticator, IL‐6 correlates positively with injury severity score (ISS) and extent of traumatic injuries , as well as with MODS . A few investigations found that levels of IL‐6 are higher in nonsurvivors of traumatic injury than survivors , thereby proposing its utility in predicting the end‐point of mortality.…”

Lessons learned from the mechanisms of posttraumatic inflammation extrapolated to the inflammatory response in COVID-19: a review

“…Alterations in local and systemic immune responses after severe trauma are recognized as a physiological reaction to restore homeostasis. The magnitude of these immunological changes correlates with the degree of local and systemic tissue damage [6,19].…”

“…Given their similar clinical profiles, there may be more similarities between severe trauma and severe cases of SARS-CoV-2 than might initially be assumed. In this review, we will consider the notion that severe disease progression in SARS-CoV-2/Corona Virus Disease 2019 (COVID- 19) patients mimics disease mechanisms that occur in complicated courses of severe trauma.…”