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Prof. Ehab Elshahat Afify :: Publications:

Title:
Combined at-admission estimation of plasma gelsolin and injury severity score could predict the outcome of multiple trauma patients
Authors: Ehab Saeed MD, Ehab El-Shahat MD
Year: 2011
Keywords: Not Available
Journal: Not Available
Volume: Not Available
Issue: Not Available
Pages: Not Available
Publisher: Not Available
Local/International: Local
Paper Link: Not Available
Full paper Ehab Elshahat Afify_101.pdf
Supplementary materials Not Available
Abstract:

Abstract Objectives: The present study aimed to estimate plasma gelsolin levels in multiple trauma patients and its predictability for their outcome in relation to clinical data. Patients & Methods: The present study included 70 multiple trauma patients and 20 healthy adult controls for blood donation as control group for the plasma level of gelsolin. All enrolled patients underwent history taking with special regard to age, sex, body weight, height and calculation of body mass index (BMI), time elapsed since trauma inflection and amount of external bleeding if present. Clinical evaluation included both Acute Physiology and Chronic Health Evaluation II (APACHE II) and Injury Severity Scores (ISS). All patients received first aid management at emergency unit and surgical interference was carried on, and patients were admitted to surgical ICU. Patients were evaluated daily throughout their ICU or hospital stay for the development of secondary morbidities and/or mortality. Venous blood samples were obtained at 12 hours after hospital admission for spectrofluorimeteric estimation of plasma gelsolin level. Results: During hospital stay, 20 patients (28.6%) developed secondary morbidities and 8 patients (11.4%) died. Mean plasma gelsolin levels were significantly lower in patients compared to control levels with significantly lower levels in non-survivors compared to controls and survivors. Development of secondary morbidities showed a positive significant correlation with at admission ISS score and a negative significant correlation with plasma gelsolin. Survival rate showed positive significant correlation with plasma gelsolin level and negative significant correlation with both time since trauma inflection and ISS score. ROC curve analysis, defined prolonged time since trauma inflection as the significant sensitive predictor for both morbidity and mortality, while plasma gelsolin level was significant specific predictor for development of secondary morbidity and combined with ISS score were significant specific predictors for mortality. Conclusion: At admission plasma gelsolin level is a specific independent marker for prediction of the development of secondary morbidities that may progress to endanger patients' life and time since trauma inflection was found to be significant sensitive parameter for the patients' survival irrespective of development of these morbidities.

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