Significance of fibrinogen, interleukin-6, and C-reactive protein as predictors of pleural complications after rib fractures in blunt chest trauma

Abstract

Introduction/Objective. Rib fractures are common in blunt chest trauma (BCT), and when they are associated with pleural complications (PC) – pneumothorax, hemothorax and hemopneumothorax – the treatment of these patients is prolonged and difficult. Without the ability to predict PC after rib fractures in BCT, most doctors are forced to initially treat these patients through observation and conservative treatment. The goal of this research is to determine which of the investigated biomarkers of inflammation – fibrinogen, interleukin-6 (IL-6), and C-reactive protein (CRP) – are significantly associated with the occurrence of PC after rib fracture in BCT, and whether they can be used in stratifying patients for hospitalization and further treatment. Methods. The prospective study included 90 patients with rib fractures caused by BCT. The test group comprised 45 patients with rib fractures and the presence of PC, and the control group consisted of 45 patients with rib fractures without PC. Blood sampling was performed on admission, on the second, third, and fifth day after the injury, and PC were monitored until the seventh day after the injury. Results. Serum values of IL-6 on the second day and fibrinogen and CRP on the second and third day after injury were statistically significantly higher in patients with PC, and IL-6 showed a good discriminative ability in assessing the occurrence of PC on the second day after a rib fracture in BCT. Conclusion. The investigated biomarkers of inflammation – fibrinogen, IL-6, and CRP – can be used as predictors of PC after rib fracture in BCT, and their application can significantly replace clinical observation.

Keywords

• blunt chest trauma
• rib fractures
• pleural complications
• fibrinogen
• il-6
• crp