The association of blood IL-1β to injury and its complications in patients with multiple trauma / 中华急诊医学杂志

ABSTRACT

Objective To investigate the relationship between the dynamic changes of interleukin-1β (IL-1β) levels and severity and complications of patients with multiple trauma at the early stage.Methods Among 97 patients with multiple trauma in Emergency Department of Shanghai Jiao Tong University Affiliated Sixth People's Hospital between August 2015 and May 2016,12 patients were excluded as follows,(1) with burns or chemical injuries;(2) pregnancy or menopausal women;(3) had bacterial infection a week ago;(4) with chronic diseases.The other 85 patients with multiple traumas were classified into three categories according to the injury severity score (ISS).That is,the slight group (22 cases,9≤ ISS ＜ 15),moderate group (35 cases,15 ≤ ISS ＜ 25) and severe group (28 cases,ISS ≥ 25).Their venous blood samples were collected at 6,12,24,48 and 72 hours after trauma respectively,and the serum IL-1 β levels were measured using a specific immunoluminometric assays.The basal conditions including age,the hospitalization days and so on among these three groups were compared via ANOVA.The mean IL-1 β levels at above time intervals among three groups were compared.Finally,the relationship between the peak concentration of IL-1β and injury severity and complications was analyzed by multiple Logistic regression.Results (1) As the increasing severity of trauma,the patients with longer days of hospitalization and higher rate of multiple organ dysfunction syndrome (MODS) (P ＜ 0.05).(2) The levels of IL-1 β in the moderate and severe groups were remarkably higher than those in the slight group (P ＜ 0.02).(3) The IL-1β levels in each group peaked at 6 hours after trauma and began to decline.(4) Multivariate logistic analysis showed that peak concentration of IL-1 β was still an independent predictor for injury severity (moderate groupodds ratio,1.21;95％ confidence interval1.05-1.39,P =0.007;severe groupodds ratio,1.20;95％ confidence interval1.03-1.40,P =0.019) and sepsis (odds ratio,1.28;95％ confidence interval1.10-1.50,P =0.001),but had no significant association with MODS and trauma mortality even after controlling other risk factors.Conclusions The serum IL-1β at 6 hours after injury could be used as an early effective indicator to evaluate the injury severity and infectionrelated complications in patients with multiple trauma.