Published: 2016-12-19

Relationship between the injury severity score and GAP score with IL-6 cytokine in fracture patients with multiple trauma

Astawa P., Aryana N. W., Pratama N. A.


Background: ISS, GAP scores and the cytokines IL-6 reflects the severity of an injury. Recently levels of the cytokine IL-6 are the best biomarker that reflects the severity of the trauma. There has been no research on the relationship between ISS and GAP scores with IL-6 cytokine level in fracture patients with multiple traumas. This study is a cross-sectional observational study.

Methods: All fracture patients treated at Sanglah Emergency Unit started in January 2016 that met the inclusion criteria became sample. At sample, we calculate ISS and GAP scores and took blood samples for examination of IL-6 cytokine level. Bivariate analysis performed by Chi-square to determine the relationship between ISS and GAP score with IL-6 cytokine level.

Results: Samples were 60 patients from January to April 2016. In this study, the correlation between the ISS and IL-6 cytokines was 0.05 (p=0.705), whereas the correlation between GAP scores and IL-6 cytokines was -0.399 (p=0.002).

Conclusions: In this study there was positive correlation that weak and not significant between the ISS and IL-6 cytokines and there was a negative correlation that had moderate strength and significant between GAP scores and IL-6 cytokines.


ISS, GAP score, IL-6 cytokine, Multiple trauma

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Trentz OL. AO Principle of Fracture Management. Chapter 5.3 Polytrauma: Pathophysiology, Priorities, and Management. New York. 2000;661-74.

Chawda MN, Hildebrand F, Pape HC, Giannoudis PV. Predicting outcome after Multiple Trauma: Which Scoring System? Int J Care Injured. 2004;35:347-58.

Kondo Y, Abe T, Kohshi K, Tokuda Y, Cook EF, Kukita I. Revised Trauma Scoring System to Predict In-Hospital Mortality in the Emergency Department: Glasgow Coma Scale, Age, and Systolic Blood Pressure Score. Critical Care. 2011;15:1-8.

Frink MJ, Griensven MV, Kobbe P, Brin T, Zeckey C, Vaske B, et al. IL-6 predicts organ dysfunction and mortality in patients with multiple injuries. Scand J Trauma Resusc Emerg Med. 2009;17:49.

Gebhard F, Pfetsch H, Steinbach G, Strecker W, Kinzl L, Brickner UB. Is interleukin an Early Marker of Injury Severity Following Major Trauma in Humans? Arch Surg. 2000;135:291-5.

Stensballe J, Christiansen M, Tønnesen E, Espersen K, Lippert FK, Rasmussen LS. The Early IL-6 and IL-10 Response in Trauma is Correlated with Injury Severity and Mortality. Acta Anaesthesiol Scand. 2009;53(4):515-21.

Lichtveld RA, Panhuizen IF, Smit RBJ, Holtslag HR, Werken CVD. Predictors of death in trauma patients who are alive on arrival at hospital. Eur J Trauma Emerg Sur. 2007;33(1):46-51.

Ahun E, Köksal Ö, Sığırlı D, Torun G, Dönmez SS, Armağan E. Value of the Glasgow Coma Scale, Age, and Arterial Blood Pressure Score for Predicting the Mortality of Major Trauma Patients Presenting to Emergency Department. Ulus Travma Acil Cerrahi Derg. 2014;20(4):241-7.