Introduction. Severity and outcome assessments are crucial in trauma. Our aim was to describe the role of a group of cytokines\n(TNF????, IL-6, IL-10, and HMGB-1) and ICAM-1 as severity and outcome assessment tools and their kinetics in the first 72 h after\nsevere trauma. Materials and Methods. Authors designed a prospective cohort study of severe polytrauma patients (ISS > 15) in a\nlevel 1 Trauma Centre. Cytokines and ICAM-1 levels and Th1/Th2 ratioswere assessed at admission, 24, 48, and 72 h. SIRS, SIRS with\nhypoperfusion, and shock were identified. Outcomes considered were ICU admission, ARDS, MODS, and death. Results. Ninetynine\npatients were enrolled (median ISS: 29 and age 31). There was an early release of pro- and anti-inflammatory mediators with\nhigher values at admission (except for ICAM-1). On admission, IL-6 was associated with ISS, IL-10 with SIRS with hypoperfusion,\nand HMGB-1 with shock. Several cytokines were associated with outcomes, especially IL-6 and IL-10 at 72 h with MODS and\ndeath. Low TNF????/IL-10 and IL-6/IL-10 ratios at 24 and 72 h were associated with MODS and death. Conclusions. Pro- and antiinflammatory\nresponses occur simultaneously and earlier after injury. Cytokines may be useful for outcome assessment, especially\nIL-6 and IL-10. Low Th1/Th2 ratio at 24 to 72 h is associated with MODS and death.
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