Abstract: To estimate plasma gelsolin levels in multiple trauma patients and its predictability for their
outcome in relation to clinical data. The study included 70 multiple trauma patients and 20 healthy adult
controls for blood donation as control group for the plasma level of gelsolin. All patients underwent history
taking, 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). 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 ICU admission for
ELISA estimation of plasma gelsolin level. 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.
[Adel F. Al-Kholy, Mosad M Odah, Jehan Sabry, Ehab El-Shahat, Ehab Said. Combined at-admission
estimation of plasma gelsolin and injury severity score could predict the outcome of multiple trauma
patients. Journal of American Science 2010;6(12):442-447]. (ISSN: 1545-1003).
Keywords: Gelsolin, Trauma, Sepsis, Morbidity, Mortality |
