Abstract
Objectives: The present study aimed to estimate plasma gelsolin levels in multiple trauma
patients and its predictability for their outcome in relation to clinical data. Patients &
Methods: The present study included 70 multiple trauma patients and 20 healthy adult
controls for blood donation as control group for the plasma level of gelsolin. All enrolled
patients underwent history taking with special regard to age, sex, body weight, height and
calculation of body mass index (BMI), time elapsed since trauma inflection and amount of
external bleeding if present. Clinical evaluation included both Acute Physiology and Chronic
Health Evaluation II (APACHE II) and Injury Severity Scores (ISS). All patients received first
aid management at emergency unit and surgical interference was carried on, and patients
were admitted to surgical ICU. Patients were evaluated daily throughout their ICU or
hospital stay for the development of secondary morbidities and/or mortality. Venous blood
samples were obtained at 12 hours after hospital admission for spectrofluorimeteric
estimation of plasma gelsolin level. Results: During hospital stay, 20 patients (28.6%)
developed secondary morbidities and 8 patients (11.4%) died. Mean plasma gelsolin levels
were significantly lower in patients compared to control levels with significantly lower levels
in non-survivors compared to controls and survivors. Development of secondary morbidities
showed a positive significant correlation with at admission ISS score and a negative
significant correlation with plasma gelsolin. Survival rate showed positive significant
correlation with plasma gelsolin level and negative significant correlation with both time
since trauma inflection and ISS score. ROC curve analysis, defined prolonged time since
trauma inflection as the significant sensitive predictor for both morbidity and mortality, while
plasma gelsolin level was significant specific predictor for development of secondary
morbidity and combined with ISS score were significant specific predictors for mortality.
Conclusion: At admission plasma gelsolin level is a specific independent marker for
prediction of the development of secondary morbidities that may progress to endanger
patients' life and time since trauma inflection was found to be significant sensitive parameter
for the patients' survival irrespective of development of these morbidities. |
