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Blood polymorphonuclear leukocyte migration as a predictive marker for infections in severe trauma: comparison with

Gerd Egger1, Reingard Aigner2, Andreas Glasner3

  • 1Institute of Pathophysiology, Karl- Franzens University, Graz, Heinrichstrasse 31, 8010, Graz, Austria. gerd.egger@eunet.at.

Intensive Care Medicine
|January 17, 2004
PubMed
Abstract

Insights

Polymorphonuclear leukocyte (PMN) migration is a sensitive predictor of infection in multiple trauma patients. This whole-blood test can help guide early antimicrobial therapy for better patient outcomes.

Area of Science:

  • Trauma Care
  • Infectious Disease Prediction
  • Immunology

Background:

  • Multiple trauma patients are at high risk for developing infections.
  • Early identification of infection risk is crucial for timely intervention.
  • Various inflammatory and stress markers are used to predict infection, but their efficacy varies.

Purpose of the Study:

  • To evaluate the predictive value of several inflammation and stress markers for infection in multiple trauma patients.
  • To specifically assess the utility of polymorphonuclear leukocyte (PMN) migration as an early infection marker.

Main Methods:

  • Prospective observational cohort study of 26 multiple trauma patients.
  • Measured white blood count, temperature, PMN migration, C-reactive protein, PMN elastase, procalcitonin, neopterin, interleukins, malondialdehyde, total antioxidative status, cortisol, and lactate.
  • Assessed PMN migration using a whole-blood membrane filter assay.

Main Results:

  • Polymorphonuclear leukocyte (PMN) migration below a critical level accurately predicted infections (sensitivity 0.88, specificity 0.82).
  • Fever also showed predictive value but with lower sensitivity (0.55).
  • Procalcitonin, elastase, C-reactive protein, neopterin, and lactate correlated with injury severity but were not significant infection predictors.

Conclusions:

  • Whole-blood PMN migration is a highly sensitive and specific predictive marker for infections in multiple trauma patients.
  • This test can facilitate early initiation of aggressive antimicrobial therapy, potentially improving patient outcomes.

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