@article{ref1,
title="Impact of injury severity on dynamic inflammation networks following blunt trauma",
journal="Shock",
year="2015",
author="Almahmoud, Khalid and Namas, Rami A. and Abdul-Malak, Othman and Zaaqoq, Akram M. and Zamora, Ruben and Zuckerbraun, Brian S. and Sperry, Jason and Peitzman, Andrew B. and Billiar, Timothy R. and Vodovotz, Yoram",
volume="44",
number="2",
pages="101-109",
abstract="INTRODUCTION: Clinical outcomes following trauma depend on the extent of injury and the host's response to injury, along with medical care. We hypothesized that dynamic networks of systemic inflammation manifest differently as a function of injury severity in human blunt trauma. STUDY DESIGN: From a cohort of 472 blunt trauma survivors studied following IRB approval, three Injury Severity Score (ISS) sub-cohorts were derived after matching for age and gender: Mild ISS (49 patients [33 males, 16 females; age 42±1.9; ISS 9.5±0.4]); Moderate ISS: (49 patients [33 males, 16 females; age 42±1.9; ISS 19.9±0.4]) and Severe ISS: (49 patients [33 males, 16 females; age 42±2.5; ISS 33±1.1]). Multiple inflammatory mediators were assessed in serial blood samples. Dynamic Bayesian Network (DyBN) inference was utilized to infer causal relationships based on probabilistic measures. <br><br>RESULTS: ICU length of stay [LOS], total LOS, days on mechanical ventilation, Marshall Multiple Organ Dysfunction Score, prevalence of pre-hospital hypotension and nosocomial infection, as well admission lactate and base deficit were elevated as a function of ISS. Multiple circulating inflammatory mediators were significantly elevated in Severe ISS vs. Moderate or Mild ISS over both the first 24 h and out to 7 days post-injury. Moderate and Mild ISS. DyBN suggested that IL-6 production in Severe ISS was affected by MCP-1/CCL2, MIG/CXCL9, and IP-10/CXCL10; by MCP-1/CCL2 and MIG/CXCL9 in Moderate ISS; and by MIG/CXCL9 alone in Mild ISS over 7 d post-injury. <br><br>CONCLUSION: ISS correlates linearly with morbidity, prevalence of infection, and early systemic inflammatory connectivity of chemokines to IL-6.<p /> <p>Language: en</p>",
language="en",
issn="1073-2322",
doi="10.1097/SHK.0000000000000395",
url="http://dx.doi.org/10.1097/SHK.0000000000000395"
}