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2012, Number 1

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Rev Cub Med Mil 2012; 41 (1)

Traumata and humoral immunity according to TRISS predictive index

Alfonso ALE, Rodríguez AM, Puerto CE, Reyes MML, Rodríguez ND, Carabeo DC

Language: Spanish
References: 20
Page: 29-37
PDF size: 175.38 Kb.


ABSTRACT

Introduction: the trauma is recognized as a non-solved epidemic of the current society, in Cuba it is a real health problem.
Objective: to determine the kinetic behavior of the humoral immunity in trauma patients, in general and in those complicated in particular, and to specify exactly the moment of great affection, as well as its relations to survival probability (SP) according the trauma predictive index "injury severity score" (TRISS).
Methods: a prospective study was conducted in 70 trauma patients with values of "injury severity score" higher than 8 admitted in the "Dr. Luis Díaz Soto" Central Military Hospital over two years, as well as immunity studies over the first 24 hours, at 3 days and at 7 days. The needed statistic tests were applied to assess the study. Sample was stratified in three groups: SP< 80 %, between 80 and 95 % and SP> 95 %.
Results: there were infectious complications significantly frequent (47,9 %). The kinetic study of the humoral immunity confirmed a decrease at 72 hours, of C-3 factor of the serum complement, of the CH-50 total hemolytic complement, and of immunoglobulin G and M. Also, there was decrease of these components in the patients complicated and in those died after, more marked at 72 hours and intensified at 7 days en these latter. Insofar as the survival probability decreased, also decreased the values of the CH-50 total hemolytic complement (p= 0.009), of the immunoglobulin G and M (p= 0.004) and the C-3 factor of serum complement. The deficiency in the humoral response was accompanied of a greater incidence of complicated and deceased patients.
Conclusions: the traumata are accompanied of humoral immunodepression and it is related to the survival probability according the predictive index-TRISS.


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