C- REACTIVE PROTEIN IN TRAUMA PATIENTS

Abstract

BACKGROUND : Trauma patients present daily in most public hospitals
in Nigeria and these patients are prone to infection if not properly
managed. The essence of this work is to determine the levels of C
reactive protein in trauma patients.
AIM: The aim of this study is to determine the levels of C-reactive
protein in the blood of trauma patients on the first, third and eighth day
following trauma with simultaneous erythrocyte sedimentation rates,
white blood cell counts and temperaturesʼ monitoring.
METHODOLOGY: The high sensitivity enzyme – linked immunosorbent
assay technique was used in analysis of C–reactive protein. Glucose
oxidase method was used for the random plasma glucose estimation
and Westergren method for erythrocyte sedimentation rate while an
autoanalyzer was used to estimate the white blood cell count.
RESULTS: The mean ages of subjects were 33.75 ± 11.52 years for
trauma patients and 31.67 ± 7.85 years for controls. Most of the trauma
patients were males (81.7%), who had attained secondary or tertiary
education. Vehicular crash was the commonest cause of trauma.
The mean white blood cell count was highest on the first day
following trauma and declined subsequently. The mean erythrocyte
sedimentation rate peaked on the eighth day while the mean random
plasma glucose had a peak on the third day following trauma. The mean
serum C–reactive protein was highest on the third day following trauma
(378.8 ± 133.0mg/L) and was found to be higher in patients who had
fractures (381.6 ± 122.7) than in those who had soft tissue injuries
(376.1 ± 143.3mg/L) P < 0.01. Those who had surgical intervention, also
had a higher mean C–reactive protein (449.5 ± 45.6mg/L) than those
who did not have surgical intervention (368.7 ± 138.4mg/L) P < 0.01.
These differences are statistically significant.
CONCLUSION: C – reactive protein levels increase in the blood of
trauma patients as a result of tissue damage but decreases after the
third day following trauma. However, in the presence of infection, the
increase is sustained and thus, it can be used to predict the presence
and onset of infection in these patients. We therefore recommend that
serial quantitative C–reactive protein measurements be done as an
adjunct to surgical care in trauma patients.

C- REACTIVE PROTEIN IN TRAUMA PATIENTS