Pneumonia in multiple injured patients: a prospective controlled trial on early prediction using clinical and immunological parameters

Objective and design: In a prospective trial 266 multiple injured patients were included to evaluate clinical risk factors and immune parameters related to pneumonia. Methods: Clinical and humoral parameters were assessed and multivariate analysis performed. Results: The multivariate analysis (odds ratio with 95% confidence interval (Cl)) revealed male gender (3.65), traumatic brain injury (TBI) (2.52), thorax trauma (AIS(thorax) greater than or equal to 3) (2.05), antibiotic prophylaxis (1.30), injury severity score (ISS) (1.03 per ISS point) and the age (1.02 per year) as risk factors for pneumonia. The main pathogens were Acinetobacter Baumannii (40 %) and Staphylococcus aureus (25 %). A tendency towards higher Procalcitonin (PCT) and Interleukin (IL)-6 levels two days after trauma was observed for pneumonia patients. Conclusion: The immune parameters (PCT, IL-6, IL-10, soluble tumor necrosis factor p-55 and p-75) could not confirm the diagnosis of pneumonia earlier than the clinical parameters.