PHYSIOLOGICAL-STATE SEVERITY CLASSIFICATION AS AN INDICATOR OF POSTTRAUMA CYTOKINE RESPONSE

A Physiologic State Severity Classification (PSSC) derived from cluste ring of 17 cardiorespiratory variables was used to predict cytokine re sponse in critically ill posttrauma patients. The PSSC defined physiol ogic states: A-State (A), normal stress response; B-State (B), metabol ic insufficiency; C-2-State (C), respiratory insufficiency. Bayesian a nalysis of these states defined a probability of death (P-death). 416 studies from 60 newly studied multiple trauma patients (70% males, Inj ury Severity Score = 27.5) were analyzed; 45 (75%) had sepsis (s), 28 (47%) had sepsis-adult respiratory distress syndrome (s-ARDS). Of 35 s urvivors (66% s, 37% s-ARDS, mean P-death =.42) 23% were predominantly A, 66% B, and 11% C. Of 25 deaths (88% s, 60% s-ARDS, mean P-death =. 64) 0% were A, 44% B, and 56% C. PSSC States were correlated with inci dence and mean-plasma levels (pl) in picograms/ml of cytokines. 23 sam ples from recovering nonseptic trauma patients were used as controls.