Increasing Procalcitonin Level of Blunt Thoracoabdominal Trauma Patients with ISS ≥ 16 in Saiful Anwar General Hospital Malang

Abstract

Background: Trauma is the leading cause of death among productive age men and continue to be the cause of years of valuable life lost compared with cancer, heart disease, and stroke in combination. Thoracoabdominal trauma has great contribution to mortality of patient due to its anatomical position, contain vital body organs, the most body impact, and oftenly without any skin injury. Early prognosis evaluation of multitrauma patient is difficult. Clinical parameters which reflect patient’s actual condition is required. Procalcitonin (PCT) has a very low level among healty individuals. PCT is known to be reliable biomarker in septic and infection cases dan has accuracy and clinical value to determine diagnosis of sepsis among critically ill patients. PCT as biomarker of SIRS in thoracoabdominal trauma and morbidity caused by SIRS has never been observed. Materials and Methods: The prospective research was done in 4 months. Blood sampels were taken twice. First was taken within 24 hours after trauma. The latter was taken 72 hours after trauma. Inclusion and exclusion criterias were included. Confounding factors were also considered. Results: 53 subjects were collected, 46 male and 7 female. 3 patients were dropped out because they died before the third day. Among 50 subjects, 25 subjects suffered from SIRS with 5 deaths, and 25 subjects were free from SIRS. Patients suffered from SIRS were included in statistical analysis. The results were mean value of PCT level in the first day was 11.178± SD 11.568, which was significantly increased in the third day 13.998 ± SD 14.496 with t value of -4.012, with level of significancy 0.001. The mean PCT level of deceased patients from the first day was 25.98 ± SD 13.47 which was significantly increased in the third day 25.98 ± SD 16.74, with t value of -4.119, with level of significancy 0.05. Pearson correlation test towards increasing levef of PCT and SIRS revealed rcounting was 0.708 with level of significancy 0.000, which means that, the more increasing level of PCT, the chance of SIRS event will also increasing. Conclusion: PCT levels obtained during research reflect high level of inflammation over patients. The higher level of PCT level was associated with the amount of pro inflammatory cytokines relased by the body. This amount of cytokines revealed the extensive tissue damage resulted from trauma. The increasing level of PCT on the third day showed the extension of tissue damage resulted from trauma, which effected in the increasing release of pro inflammatory cytokines. It was concluded that blunt thoracoabdominal trauma patients suffered from SIRS, had increasing level of PCT.