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 (BTC) 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 BTC, 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, IL-6 and CRP are significantly associated with the occurrence of PC after rib fracture in BCT, which would be used in stratifying patients for hospitalization and further treatment. Methods The prospective study included 90 patients with rib fractures caused by BTC. 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 BTC. Conclusion The investigated biomarkers of inflammation - fibrinogen, IL-6 and CRP can be used as predictors of PC after rib fracture in BTC, and their application can significantly replace clinical observation.