Abstract
Objective: To study the kinetics of calprotectin and calgranulin C in the serum of patients with polytrauma, to evaluate the serum levels of both the proteins as predictors of nosocomial infection (NI), and to compare calprotectin and calgranulin C with routine biomarkers and scoring systems. Design: Monocentric, prospective, clinical study Setting: University Hospital ICU Materials and methods: The study included 25 polytrauma patients and 20 healthy volunteers.
The blood specimens were collected on admission (day 1) and then on days 3, 5 and 7 of hospitalization. Concentrations of calprotectin and calgranulin C were determined by enzyme immunometric assay.
Patients were scored with Injury Severity Score, Acute Physiology And Chronic Health Evaluation II a Sequential Organ Failure Assessment Score (SOFA). The white blood cell count and the serum concentrations of the C-reactive protein (CRP), procalcitonin (PCT), glucose and lactate were the measured routine biomarkers.
Other parameters included length of ICU stay, duration of mechanical ventilation, antibiotic therapy and development of nosocomial infection. Results: Significant elevations of the calprotectin and calgranulin C serum levels in trauma patients in comparison to healthy subjects were observed during the whole study period.
Concentrations of both the proteins correlated positively with the SOFA score on days 1 and 3, CRP and PCT on day 3; and calprotectin also correlated with CRP on day 5. A trend of low serum levels of calprotectin a calgranulin C was observed in patients with nosocomial infection (n=10).
In addition, these patients had significantly higher glycaemia on days 1, 3 and 5 in comparison to patients without infectious complication (n=8). Conclusions: The results suggest calprotectin and calgranulin C serum levels as suitable biomarkers of severe injury.