Post-traumatic multiple organ dysfunction and elevated sE-selectin levels

Abstract

Objective: To investigate the changes in sE-selectin levels in the circulation of patients with major trauma, and to establish whether these changes are correlated with injury severity and multiple organ dysfunction (MOD). Patients and methods: 40 traumatic patients with injury severity score (ISS) of 16 or over and 20 healthy volunteers (control group) were included in the study. Blood samples were taken from healthy volunteers once, and from traumatic patients first during the 6 hours after the trauma, and then after 1, 3, 5 and 7 days. sE-selectin level was analyzed in these samples using enzyme-linked immunosorbent assay method. Patients were divided into two different groups: those developing and those not developing MOD according to Denver score. Results: sE-selectin levels of traumatic patients did not show any changes compared with the control group during the first 6 hours. sE-selectin level showed a significant increase from the 1st day onwards and continued until the third day. The levels at 3rd day remained almost constant until the 5th day, thereafter dropping down to the level of the 1st day. In addition, time-related changes observed in sE-selectin levels presented similar trends in patients with or without MOD. However, sE-selectin levels were significantly higher in patients with MOD from the first day onwards. No correlation could be established between ISS and sE-selectin level and between ISS and MOD. Conclusion: These findings show that sE-selectin level increases significantly starting from the first day after the trauma, independent of the severity of the injury. High levels of sE-selectin in patients with MOD development may be utilized as a tool in the early determination of MOD.