Admission level of Gc-globulin predicts outcome after multiple trauma

• Published in: Injury Vol. 30; no. 4; pp. 275 - 281
• Main Authors: Dahl, Benny, Schiødt, Frank Vinholt, Nielsen, Michael, Kiær, Thomas, Williams, John G., Ott, Peter
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.1999; Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; Biomarkers - blood; Female; Humans; Male; Medical sciences; Multiple trauma; Multiple Trauma - blood; Multiple Trauma - diagnosis; Predictive Value of Tests; Prognosis; Prospective Studies; ROC Curve; Sensitivity and Specificity; Survival Rate; Trauma Severity Indices; Traumas. Diseases due to physical agents; Vitamin D-Binding Protein - blood; Human; Prognosis; Biological marker; Gc-System; Trauma; Survival; Globulin; Actin; Adult; Serum; Severity score; Predictive factor; Multiple injury; Comparative study; Quantitative analysis
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/S0020-1383(99)00080-7

Background: Actin is the dominating protein in mammalian cells. Release of excessive amounts of actin into the circulation may result in a condition resembling multiple organ failure. The purpose of this study was to determine if admission levels of Gc-globulin can predict survival after multiple trauma. Also, we wanted to compare the predictive ability of Gc-globulin with that of the TRISS–Like scoring system. Methods: Fifty-seven patients with a median ISS 18 (16–75) were included. All patients had a blood sample taken median 42 min after the injury (19–110 min). Serum Gc-globulin was measured by rocket immunoelectrophoresis. Results: On admission, all patients had significantly reduced levels of Gc-globulin compared with normal controls. Gc-globulin was significantly higher in the group of survivors ( n=41), compared with non-survivors ( n=16). Median 237 mg/l vs. 188 mg/l ( P<0.01). The predictive ability of Gc-globulin regarding death was similar to that of TRISS–Like with positive predictive values of 69%, a negative predictive value of 84%, a sensitivity of 56% and a specificity of 90%. Conclusions: The predictive value of Gc-globulin regarding survival was similar to that of an established scoring system. Gc-globulin, alone or in combination with other parameters, may serve as a routine tool for early identification of patients at risk after severe injury, increasing the possibility of early intervention.