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- Trauma
- Predictive value of elevated interleukin-33 levels for multi-organ dysfunction syndrome in trauma patients in South Korea: a prospective observational study
- Sanghyun An, In Sik Shin, Myoung Jun Kim, Da Kyung Kim, Md Habibur Rahman, Cheol-Su Kim, Kwangmin Kim
- Acute Crit Care. 2025;40(4):594-604. Published online November 28, 2025
- DOI: https://doi.org/10.4266/acc.002500
- 943 View
- 71 Download
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Abstract
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Supplementary Material - Background
Multi-organ distress syndrome (MODS) causes morbidity in patients with trauma. This study evaluates the effectiveness of interleukin-33 (IL-33), which reflects tissue damage and the inflammatory response, as a MODS indicator in patients with trauma.
Methods
Patients with trauma admitted to our trauma center between July 2022 and July 2023 were included. IL-33 levels were measured in blood samples for 4 days. Correlations with clinical and laboratory indicators, including initial IL-33 levels, were analyzed to identify independent predictors of MODS.
Results
Among the 87 patients enrolled, 20 developed MODS. Initial IL-33 levels were elevated in the MODS group, compared with the non-MODS group. In the non-MODS group, IL-33 levels increased on day 1 and then declined, whereas in the MODS group, IL-33 levels were highest at admission (day 0) and decreased continuously through day 3. In patients with detectable initial IL-33 levels, the measured levels correlated with higher Abbreviated Injury Scale 5 scores and the Injury Severity Score (ISS). A logistic regression analysis revealed the ISS and delta neutrophil index as factors contributing to MODS progression.
Conclusions
The findings suggest that initial IL-33 levels are elevated in the MODS group, compared with non-MODS group, and exhibit a rapidly declining trend, showing an initial association with MODS that was not maintained in a multivariate analysis. These findings suggest that IL-33 might have relevance in assessing trauma severity; however, further validation is required before it can be considered a biomarker for MODS.
- Trauma
- Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture
- Kang Min Kim, Myoung Jun Kim, Jae Sik Chung, Ji Wool Ko, Young Un Choi, Hongjin Shim, Ji Young Jang, Keum Seok Bae, Kwangmin Kim
- Acute Crit Care. 2022;37(2):247-255. Published online April 22, 2022
- DOI: https://doi.org/10.4266/acc.2021.01396
- 8,466 View
- 240 Download
- 9 Web of Science
- 10 Crossref
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Abstract
PDF
- Background
Several recent studies have shown that preperitoneal pelvic packing (PPP) effectively produces hemostasis in patients with unstable pelvic fractures. However, few studies have examined the rate of surgical site infections (SSIs) in patients undergoing PPP following an unstable pelvic fracture. The purpose of the present study was to evaluate factors associated with SSI in such patients.
Methods
We retrospectively reviewed the medical charts of 188 patients who developed hemorrhagic shock due to pelvic fracture between April 2012 and May 2021. Forty-four patients were enrolled in this study.
Results
SSI occurred in 15 of 44 patients (34.1%). The SSIs occurred more frequently in cases of repacking during the second-look surgery (0 vs. 4 [26.7%], P=0.010) and combined bladder-urethra injury (1 [3.4%] vs. 4 [26.7%], P=0.039). The incidence of SSIs was not significantly different between patients undergoing depacking within or after 48 hours (12 [41.4%] vs. 5 [33.3%], P=0.603). The mean time to diagnosis of SSI was 8.1±3.9 days from PPP. The most isolated organism was Staphylococcus epidermidis.
Conclusions
Repacking and combined bladder-urethra injury are potential risk factors for SSI in patients with unstable pelvic fracture. Close observation is recommended for up to 8 days in patients with these risk factors. Further, 48 hours after PPP, removing the packed gauze on cessation of bleeding and not performing repacking can help prevent SSI. Additional analyses are necessary with a larger number of patients with the potential risk factors identified in this study. -
Citations
Citations to this article as recorded by
- An Atypical Presentation of Morel–Lavallée Syndrome Following Blunt Trauma
Shreya Nair , Anoop V Pillai, Riju Ramachandran
Cureus.2026;[Epub] CrossRef - Pelvic packing – status 2024
Axel Gänsslen, Tim Pohlemann, Jan Lindahl, Jan Erik Madsen
Archives of Orthopaedic and Trauma Surgery.2025;[Epub] CrossRef - Operatively treated high-energy blunt pelvic ring injuries and surgical site infections – A retrospective assessment based on a prospective registry
Elvin Gurbanov, Ulysse Coneys, Elisabeth Andereggen, Alexandre Ansorge, Vanessa Morello, Axel Gamulin
Injury.2025; 56(3): 112209. CrossRef - Timing of planned reoperation after damage control surgery in patients with trauma: a systematic review and meta-analysis
Dongmin Seo, Hye Young Woo, Inhae Heo, Kyoungwon Jung, Hohyung Jung
World Journal of Emergency Surgery.2025;[Epub] CrossRef - Angioembolization Has Similar Efficacy and Lower Total Charges than Preperitoneal Pelvic Packing in Patients With Pelvic Ring or Acetabulum Fractures
Aaron Singh, Travis Kotzur, Ezekial Koslosky, Rishi Gonuguntla, Lorenzo Canseco, David Momtaz, Ali Seifi, Case Martin
Journal of Orthopaedic Trauma.2024; 38(5): 254. CrossRef - Factors Associated With Pelvic Infection After Pre-Peritoneal Pelvic Packing for Hemodynamically Unstable Pelvic Fractures
Jennifer E. Baker, Husayn A. Ladhani, Caitlyn McCall, Chelsea R. Horwood, Nicole L. Werner, Barry Platnick, Clay Cothren Burlew
Surgical Infections.2024; 25(5): 399. CrossRef - Comparison of Conventional versus Modified Preperitoneal Pelvic Packing in Patients with Bleeding Pelvic Fractures: A Single-Center Retrospective Pilot Study
Sebeom Jeon, Byungchul Yu, Gil Jae Lee, Min A Lee, Jungnam Lee, Kang Kook Choi
Journal of Clinical Medicine.2024; 13(14): 4062. CrossRef - Current Management of Hemodynamically Unstable Patients with Pelvic Fracture
Kevin Harrell, Chelsea Horwood, Clay Cothren Burlew
Current Surgery Reports.2023; 11(4): 92. CrossRef - Open Fixation After Preperitoneal Pelvic Packing Is Associated With a High Surgical Site Infection Rate
Ye Joon Kim, Bryan L. Scott, Fredric M. Pieracci, Ernest E. Moore, Cyril Mauffrey, Joshua A. Parry
Journal of Orthopaedic Trauma.2023; 37(11): 547. CrossRef - Extraperitoneal pelvic packing in trauma – a review
Sajad Ahmad Salati
Polish Journal of Surgery.2022; 95(3): 46. CrossRef
- An Atypical Presentation of Morel–Lavallée Syndrome Following Blunt Trauma
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