[Cytokine levels in patients with multiple injuries].

Background: The role of cytokines in trauma still has not been satisfactorily elucidated. Multiorgan failure (MOF) development should be also under the direction of cytokines, endotoxin, and other mediators.

Methods And Results: Therefore we prospectively studied 88 patients with multiple trauma admitted to Traumatological Hospital Brno from June 1, 1992 to May 31, 1993. Extent of the trauma was determined by Injury Severity Score (ISS), Revised Trauma Score (RTS), and TRISS methodology with probability of survival. In study patients was investigated concentrations of interleukin 1, 2, 6, and tumor necrosis factor (TNF). Of above mentioned cytokines were elevated only IL-6 levels at admission and significant correlation with ISS was found (r = 0.32; p < 0.01). MOF developed in 23 patients (12 of them died), but it was not possible to predict the MOF development nor surviving according to admission levels of cytokines. A significant difference was observed in IL-6 levels of MOF patients one day before death (439 +/- 111 ng/l) in comparison with MOF patients, who survived (132 +/- 88 ng/l, p < 0.001). None of 12 MOF patients with IL-6 concentrations above 400 ng/l survived.

Conclusions: We conclude that IL-6, less TNF, seems to play an important role in organism response to multiple trauma, and later elevation in these cytokines levels, especially IL-6 level, in MOF patients mean poor prognosis. We had found a significant correlation between initial IL-6 level and ISS. Other cytokines did not show changes during the study.