PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 9403752

Circulating complement proteins in multiple trauma patients--correlation with injury severity, development of sepsis, and outcome.

F Hecke·U Schmidt·A Kola·W Bautsch·A Klos·J Köhl
View original source ↗Export metadata ↓

Abstract

OBJECTIVE: To investigate protein complement 3a (C3a) and protein complement 3 (C3) plasma levels in trauma patients directly after the injury, in relation to the patients' outcome, the development of sepsis, or the injury severity, as determined by either the Polytrauma Score (PTS), the Injury Severity Score (ISS), or the Trauma and Injury Severity Score (TRISS). DESIGN: Prospective study. SETTING: Surgical intensive care unit in a university hospital. PATIENTS: Thirty-four patients with multiple trauma. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: C3a and C3 concentrations, as well as the C3a/C3 ratio, were determined at the time of the accident (T0), at the emergency admission (T1), 8 hrs after the accident (T2), and every 8 hrs until day 3, every 12 hrs until day 6, and once daily on days 7 and 8. The C3a plasma concentrations and the C3a/C3 ratios of nonsurvivors were significantly greater at T0 or T1 as compared with those survivors (p = .008 or .033). Patients who developed sepsis had higher C3a plasma levels at the scene of accident than patients without complications. However, these differences did not reach statistical significance (p = .051), although a clear trend was apparent. Patients were grouped according to the severity of injury, as determined by either the PTS, ISS, or TRISS. We found significant differences in the both the mean C3a values and the C3a/C3 ratio among the different groups, during the first 8 hrs after the injury. In addition, a significant correlation was observed between the C3a concentration or the C3a/C3 ratio at T0 to T2 and either the ISS (r2 = .49), PTS (r2 = .22) or the TRISS (r2 = .45), which was similar to correlations between injury severity scores themselves (r2 = .36 to .58). CONCLUSIONS: Complement activation occurs immediately after the injury. The degree of activation is a hallmark for the outcome of a patient. Determination of C3a concentrations, at the scene of the accident, may prove helpful to assess the severity of the injury and to determine the prognosis. The amount of C3a and the C3a/C3 ratio may be useful as additional parameters to the existing trauma scoring systems, such as, PTS, ISS, and TRISS.

Explore related subjects

Accidents, TrafficAdultComplement C3Complement C3aEmergenciesHumansInjury Severity ScoreMultiple TraumaProspective StudiesRespiratory Distress SyndromeSepsisComparative StudyJournal ArticleResearch Support, Non-U.S. Gov't

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

F Hecke, U Schmidt, A Kola, W Bautsch, A Klos, J Köhl. 1997. Circulating complement proteins in multiple trauma patients--correlation with injury severity, development of sepsis, and outcome.. https://doi.org/10.1097/00003246-199712000-00019

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed1999

Relative excess risk: an alternative measure of comparative risk.

The proverbial relative risk may not always be the most suitable measure to compare the risk of two exposures, since it inherently includes a background effect. An alternative comparative measure, the relative excess risk, is introduced. It applies to situations in which an "unexposed" reference group is included in addition to the two exposures under evaluation. This comparative measure is based solely on the component of risk due to the exposures, since it removes the background risk. Estimators of the relative excess risk are presented, along with formulas for the confidence intervals under cohort and case-control designs, using both crude and adjusted rate ratios. This new measure is illustrated with data from epidemiologic studies of the risks of oral contraceptives and antidiabetic drugs.

Accidents, Traffic↗
PubMed1999

Four legs or two: up front with you--preventing tragedies by keeping children and pets out of the cargo areas of pickup trucks.

Dogs and children riding in the cargo area of pickup trucks are common sights on our nation's highways, country roads, and small town streets. This scene brings to mind idyllic childhoods filled with summer days spent bouncing down roads in the back of grandpa's pickup truck, wind catching the laughter from children's throats. For hundreds of families each year, this activity is the cause of heartache, traumatic injuries, and senseless deaths. More than 200 people die each year, half of whom are younger than 18 years of age, as a direct result of falls from cargo areas of pickup trucks. Injuries and deaths resulting from riding in cargo areas of pickup trucks are not limited to humans. In a recent survey, 71% of veterinarians reported treating dogs for injuries sustained by falling or jumping from cargo areas of pickup trucks. This percentage does not take into account countless dogs that were killed and not treated. Injuries and deaths resulting from riding in cargo areas of pickup trucks are preventable. Whereas it may take millions of dollars and many years to cure diseases such as cancer, heart disease, and AIDS, pickup truck-associated deaths can be prevented simply by educating the public to not allow children and pets to ride in cargo areas. The primary objective of "Four legs or two: Up front with you" is to educate the public on the risks involved with travel in the cargo areas of pickup trucks. Making people aware that children and pets are not cargo is the first step toward decreasing senseless injuries and deaths.

Accidents, Traffic↗
PubMed1999

[Citalopram in forensic samples. Citalopram concentrations in samples from legal autopsies and from living persons in connection with traffic accidents or cases of violence in Denmark 1989-1996].

Citalopram was found in 92 autopsy cases and 27 cases from living persons and the concentrations are described. A range of 6.2-19 mumol/kg whole blood was found in cases where citalopram alone was the cause of death and a range of 1.9-16 mumol/kg whole blood in cases, where citalopram together with other compounds were considered to be the cause of death. In autopsy cases toxic concentrations were in the range 1.2-2.8 mumol/kg whole blood and concentrations between 0:09 and 1.9 mumol/kg were considered therapeutic. In cases from living persons the citalopram concentrations in whole blood were 0.06-0.9 mumol/kg.

Accidents, Traffic↗