Early Biochemical Changes and Severity of Injury in Man

Abstract

To investigate whether biochemical changes soon after injury could be used as a measure of its severity or to predict its outcome the relationships of an injury severity score, initial blood metabolite concentrations and subsequent biochemical changes were studied in 33 injured patients. At about 4 h after injury severity was related directly to blood lactate, pyruvate, and alanine (P < 0.01), and inversely to blood ketone body concentrations (P < 0.05). In 19 patients the daily total N, histidine, and 3-methylhistidine excretion was measured for 7 days. Only total urinary N was related to injury severity; 3-methylhistidine was inversely related to initial ketone body concentration; and histidine excretion was related to initial lactate, pyruvate and alanine concentration. Certain early biochemical measurements are significantly related to the severity of injury and thus may be of practical importance.