Dynamic change of serum myoglobin and its clinical significance in multiple trauma patients

Abstract

Objective To investigate the dynamic change of serum myoglobin and assess its relation with injury severity in multiple trauma patients. Methods The concentration of serum myoglobin in 41 multiple trauma patients （ISS ≥16 points） was detected at days 1,3,7 and 14 after injury. In the meantime, injury severity score （ ISS）, Glasgow coma score （ GCS）, simplified acute physiology score Ⅱ（ SAPS Ⅱ ）, percentage of the injured muscle and soft tissue to entire body, shock on admission and ultimate outcomes were recorded at day 1 after injury. All patients were divided into ISS ≥25 group or ISS 〈 25 group, survival group or death group based on the injury severity and ultimate outcomes. The dynamic changes of the serum myoglobin were observed and compared between the groups. The correlation of the serum myoglobin concentration with ISS, GCS, SAPS Ⅱ score, shock and the percentage of injured muscle and soft tissue was investigated. Results The serum myoglobin concentration in ISS ≥ 25group was decreased more slowly than that in the ISS 〈 25 group, with higher concentration of the serum myoglobin concentration in the ISS ≥ 25 group than that in the ISS 〈 25 group at all time points. The serum myoglobin concentration in the death group was increased first, then slowly declined and reached peak at day 3. While in survival group, the serum myoglobin concentration was continuously decreased, with lower serum myoglobin concentration than that in the death group at all time points. The serum myoglobin concentrations were positively correlated with the SAPS Ⅱ score at all time points, with ISS at days 7 and 14, with the percentage of the injured area at day 1 and with the shock at days 1 and 3, while the serum myoglobin concentration was negatively correlated with GCS at days 3,7 and 14. Conclusions The dynamic changes of the serum myoglobin concentration in multiple trauma patients may reflect the severity,trends and prognosis of the injury, and hence can be used as effective index for monitoring the disease. Key words: Multiple trauma; Myoglobin ; Shock ; Injury severity score