PREDICTION OF FUNCTIONAL IMPAIRMENTS IN THE IMMUNE AND HEMOSTATIC SYSTEMS, BY USING THE CLINICAL RATING SCALE (FS-SS) IN VICTIMS OF POLYTRAUMA
Whether functional impairments in the immune and henostatic systems might be predicted from the severity of clinical condition rated by the FS-SS scale in victims of polytrauma was studied. Sixty-five victims of polytrauma (ISS: 29.7 ± 2.43 scores) treated in the Field Surgery Clinic, Military Medical Academy, in 2007-2009, were examined. The studies have indicated that on day 1 of polytrauma, immunological responsiveness and endothelial vascular function are determined by the severity of an injury and the amount of blood loss, which were similar in victims with severe sepsis and in those without sepsis. The values of CD14+ < 58%, CD14+ HLAII+ < 31%, CD95+ lymphocytes > 15%, the serum levels of IL-6 pg/ml, endothelin > 0.8 fmol/ml on day 3 posttrauma may be used as a predictor of severe sepsis and the count of the monocytes CD14+ < 40% and CD14+ HLAII < 35% on days 5-7 after injury may be used for its diagnosis. A strong correlation is detectable between the victims clinical condition rated in FS-SS scores and the parameters of immunological responsiveness, vascular endothelial function, and external respiration. Thus, the FS-SS scale not only objectively characterizes the clinical condition of a victim, but also gives a speculative insight into immunological responsiveness, vascular endothelial function, and external respiration at each specific moment of traumatic disease.