Severe head injury (SHI) leads to systemic immunosuppression, which is processed by central mechanisms and is associated with a high risk of pneumonia. The timely identification of an immunodepressed condition in SHI patients might help prevent infections by changing the intensive care strategy. The aim of this prospective study is to evaluate a new method for identifying immunodepression and predicting pneumonia. We correlated interleukin (IL)-6 levels determined by the standard test (Immulite) and performed by specialized laboratories with those obtained using the new bedside test (PicoScan) with the occurrence of pneumonia in patients with SHI. Thirty-two patients with isolated SHI were investigated. Analyses were performed on serum samples taken 2 to 24 hours after trauma. Pearson correlation coefficient was 0.924 (P<0.001) for IL-6 values determined by PicoScan versus Immulite and Spearman ρ was 0.572 for visual interpretation versus Immulite (P=0.01). Immulite and PicoScan have a positive predictive value of 91% and 100%, respectively, and a negative predictive value of 76% and 86%. The present study investigated for the first time the determination of IL-6 concentrations by PicoScan in patients. Our findings show a good correlation with the results of the standard Immulite test and suggest that the PicoScan may be used as a handy tool to predict pneumonia in SHI patients.
*Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum (CVK)
‡Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum (CVK), Coordinating Center for Clinical Studies, Augustenburger Platz 1
†Charité-Universitätsmedizin Berlin, Campus Charité Mitte (CCM), Institute of Medical Immunology, Schumannstr. 20/21, Berlin, Germany
Supported by a university research grant from the Charité (SIST 531). No financial support from Milenia Biotec or DPC Biermann was received and no financial connection exists to the authors.
Reprints: Hans-Georg Schlosser, MD, PhD, Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum (CVK), Augustenburger Platz 1, 13353 Berlin, Germany (e-mail: firstname.lastname@example.org).
Received for publication May 3, 2005; accepted August 22, 2006