medigraphic.com
ISSN 1561-3046 (Electronic)

2012, Number 1

<< Back Next >>

Rev Cub Med Mil 2012; 41 (1)

Usefulness of TRISS index as a predictor of alterations in CD3+ lymphocytes in injured patients

Rodríguez ND, Rodríguez AM, Alfonso ALE, Quintana RM, Valle LY, Garcés SY, Quintana RM

Language: Spanish
References: 34
Page: 76-86
PDF size: 181.29 Kb.


ABSTRACT

Introduction: the current trends and projections regarding traumata demonstrate that they become a public health world crisis.
Objective: to assess the usefulness of the "trauma injury severity score (TRISS) predictive index as predictor index of alterations in the subpopulations of CD3+ lymphocytes in injured patients.
Methods: an analytic and prospective study was conducted in 55 patients with trauma admitted in the "Luís Díaz Soto" Central Military Hospital between 2005 and 2008. Immunologic tests were carried out. The immunologic variables, TRISS-survival probability, complications and the status at discharge were the more important ones. Different statistic methods were used.
Results: there was predominance of infectious complications. In the deceased ones, the immunity depletion was the more significant. Insofar as the survival probability decreased, according to the TRISS-predictive index, the CD3+ lymphocyte populations were affected. The immunological alterations were more intensive in the deceased patients and in those with a poor prognosis. The major immune affections appeared during the first week.
Conclusions: the cellular immunity alterations of the traumatized patients have a direct relation to the severity of injuries affecting the survival probability of patients, according to the TRISS predictive index, confirming its predictor value in the integral assessment of this type of injured patient.


REFERENCES

  1. John HD, Jeffrey HP, Basil AP. Historia. En: Mattox KL, Feliciano DV, Moore EE. Trauma. México, DF: McGraw-Hill Interamericana; 2001. p. 3-20.

  2. Breasted JH. The Edwin Smith Surgical Papyrus. Chicago: University of Chicago Press; 1930.

  3. Comité de Trauma del Colegio Americano de Cirujanos. Evaluación y tratamiento iniciales. En: Curso avanzado de apoyo vital en trauma para médicos. Chicago; 1994. p. 19-52.

  4. García Gutiérrez A, Larrea Fabra ME, Moreno del Toro JL, Pereira Riverón R, del Cueto Espinosa H, Ceballos Mesa A et al. Traumatismos. En: García Gutiérrez A, Pardo Gómez G. Cirugía. La Habana: Editorial Ciencias Médicas; 2008. p. 539-690.

  5. Ministerio de Salud Pública. Mortalidad. En: Anuario Estadístico de Salud 2008. La Habana: Ministerio de Salud Pública. Dirección Nacional de Registros Médicos y Estadística de Salud; 2009. p. 27-92.

  6. Kudsk KA, Brown RO. Apoyo nutricional. En: Mattox KL, Feliciano DV, Moore EE. Trauma. México, DF: McGraw-Hill Interamericana; 2001. p. 1465-506.

  7. Peña Martínez J. Sistema inmune. En: Peña Martínez J. Inmunología. Madrid: Ediciones Pirámide; 1998. p. 33-46.

  8. Faist E, Wichmann M, Baue A. La respuesta inmunitaria. En: Mattox KL, Feliciano DV, Moore EE. Trauma. México, DF: McGraw-Hill Interamericana; 2001. p. 1507-25.

  9. Bandyopadhyay G, Laudanski K, Li F, Lentz C, Bankey P, Miller-Graziano C. Negative signalling contributes to T-cell anergy in trauma patients. Crit Care Med. 2007;35(3):794-801.

  10. Miller AC, Rashid RM, Elamin EM. The "T" in trauma: the helper T-cell response and the role of immunomodulation in trauma and burn patients. J Trauma. 2007;63(6):1407-17.

  11. Navarro-Zorraquino M, García-Álvarez F, Martínez- Fernández AR, Pastor C, Larrad L, Salinas JC et al. Pharmacological immunomodulation of surgical trauma. J Invest Surg. 2007;20(5):283-9.

  12. Gryglewski A, Majcher P, Szczepanik M. Immunological aspects of trauma. Postepy Hig Med Dosw. 2006;60(1):192-200.

  13. Champion HR, Copes WS, Sacco WJ. Improved predictions from A Severity Characterization of Trauma (ASCOT) over Trauma and Injury Severity Score (TRISS): Results of an Independent Evaluation. J Trauma. 1996;40(1):42-8.

  14. Civil ID. The Abbreviated Injury Scale. Revision: a condensed chart of clinical use. J Trauma. 1988;28(1):87-90.

  15. Boyd CR, Tolson MA, Copes WS. Evaluating Trauma Care: The TRISS Method. J Trauma. 1987;27(4):370-8.

  16. Champion HR, Sacco WJ, Cornazzo AJ, Copes WS, Fouty WJ. Trauma Score. Crit Care Med. 1981;9(9):672-6.

  17. Champion HR, Sacco WJ, Hunt TK. Trauma severity scoring to predict mortality. World J Surg. 1993;7(1):4-11.

  18. Manual del SPSS. Guía para el análisis de datos versión 17.00 para el Windows. Madrid: Hispanoportuguesa/SPSS [Internet]. 2008 [citado 27 Ago 2009]. Disponible en: http://www.emagister.com/guia-rapida-spss-para-windows-cursos-1076231.htm

  19. Cox DR, Hinkely DV. Theoretical statistics. New York: Chapman and Hall Ltd; 1974. p. 11-56.

  20. Canavos GC. Probabilidad y estadística. Aplicaciones y métodos. La Habana: Editorial Félix Varela; 2006. p. 303-53.

  21. Arce Bustabad S. Inmunología en la Cirugía. En: García Gutiérrez A, Pardo Gómez G. Cirugía. La Habana: Editorial Ciencias Médicas; 2008. p. 132-47.

  22. Peña Martínez J. Células inmunocompetentes. En: Peña Martínez J. Inmunología. Madrid: Ediciones Pirámide; 1998. p. 47-61.

  23. Peña Martínez J. Receptor antígeno célula T. En: Peña Martínez J. Inmunología. Madrid: Ediciones Pirámide; 1998. p. 131-47.

  24. Arce Bustabad S. Síndrome general de adaptación y los reajustes de larespuesta inmunitaria en el estrés. En: Arce Bustabad S. Inmunología clínica y estrés. La Habana: Editorial Ciencias Médicas; 2007. p. 50-64.

  25. Rodríguez Acosta M, Vázquez González T, Castellanos Puerto E, Alfonso Alfonso LE, Rojas Moya A, Jonnston Dreke N. Evaluación inmunológica del paciente politraumatizado. Rev Cubana Med Mil. 2000;29(1):12-9.

  26. Makarenkova VP, Banzal V, Matta BM, Pérez LA, Ochoa JB. CD11b+/Gr-1+ Myeloid Suppressor Cells Cause T cell Dysfunction after Traumatic Stress. J Immunol. 2006;176(4):2085-94.

  27. Venet F, Chung CS, Monneret G, Huang X, Horner B, Garber M, et al. Regulatory T cell populations in sepsis and trauma. J Leukoc Biol. 2008;83(3):523-35.

  28. Alfonso Alfonso LE. Repercusión de los traumatismos sobre el sistema inmunológico y su correlación con el índice predictivo TRISS. Tesis para optar por el Grado Científico de Doctor en Ciencias Médicas. La Habana: ISMM "Dr. Luis Díaz Soto"; 1998.

  29. Arce Bustabad S. Sistema nervioso, sistema endocrino y sistema inmune. Sus interacciones recíprocas. En: Arce Bustabad S. Inmunología clínica y estrés. La Habana: Editorial Ciencias Médicas; 2007. p. 16-34.

  30. Yadav K, Zehtabchi S, Nemes PC, Miller AC, Azher M, Durking H, et al. Early immunologic responses to trauma in the emergency department patients with major trauma. Resuscitation. 2009;80(1):83-8.

  31. Dong N, Jin BQ, Yao YM, Yu Y, Cao YJ, He LX, et al. Change in T cell-mediated immunity an its relations slip with high morbility group box-1 protein levels in extensively burned patients. Zhonghua Wai Ke Za Zhi. 2008;46(10):759-62.

  32. Gryglewski A, Majcher P, Szczepanik M. Immunological aspects of trauma. Postepy Hig Med Dosw. 2006;60(1):192-200.

  33. Wu J, Wang JX, Su WL, Shu WX, Lu JW, Li ZK. Effect of astragalus injection on serious abdominal traumatic patients cellular Immunity. Chin J Integr Med. 2006;12(1):29-31.

  34. Maile R, Barnes CM, Nielsen AI, Meyer AA, Frelinger JA, Cairns BA. Lymphopenia induce homeostatic proliferation of CD8+ T cell is a mechanism for effective allogeneic skin graft injection following burn injury. J Immunol. 2006;176(11):6717-26.




2020     |     www.medigraphic.com