-Original-

Systemic Inflammatory Response Syndrome Score at Admission Predicts Injury Severity, Organ Damage and Serum Neutrophil Elastase Production in Trauma Patients

Yuichiro Sakamoto^1,2, Kunihiro Mashiko^1,2, Hisashi Matsumoto^1,2, Yoshiaki Hara^1,2, Noriyoshi Kutsukata^1,2 and Hiroyuki Yokota¹

¹Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Nippon Medical School
²Department of Emergency and Critical Care Medicine, Nippon Medical School Chiba Hokusoh Hospital

Background: Systemic inflammatory response syndrome (SIRS) is a clinical condition representing the culmination of the activation of a complex network of acute endogenous mediators.
Materials and Methods: We investigated both the relationship between the results of SIRS assessments in 212 trauma patients at the time of hospital arrival and measures of trauma severity determined using the Injury Severity Score (ISS) and the Revised Trauma Score (RTS). We then considered the possibility of whether this assessment could be used to predict the development of organ dysfunction as a complication in trauma patients after admission. The serum neutrophil elastase (SNE) level was also measured in 47 cases.
Results: The cases with SIRS had a significantly higher ISS and a lower RTS. Organ dysfunction occurred in 22 cases, and a significant correlation was noted between the development of organ dysfunction and the presence of SIRS (86.4%; 19 cases/22 cases, p=0.0007) at the time of arrival. The SNE level was significantly higher among the patients who fulfilled the four SIRS criteria than among the other patients (p=0.0301).
Conclusion: We concluded that the greater the SIRS score at the time of hospital arrival, the greater the anatomical and physiological severity of the trauma patient's condition.

J Nippon Med Sch 2010; 77: 138-144

Keywords
systemic inflammatory response syndrome (SIRS), Injury Severity Score (ISS), Revised Trauma Score (RTS), probability of survival (Ps), neutrophil elastase, trauma

Correspondence to
Yuichiro Sakamoto, Department of Emergency and Critical Care Medicine, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
y-sakamoto@nms.ac.jp

Received, December 21, 2009
Accepted, January 22, 2010