Kinetics of Angiopoietin-2 in serum of multi-trauma patients: Correlation with patient severity

Background: Angiopoietin-2 (Ang-2) is considered a proinflammatory mediator promoting vascular leakage. Its participation in the inflammatory process following multiple injuries was investigated. Methods: Blood was sampled on consecutive days from 54 patients with multiple injuries and six healthy volunteers. Ang-2 was estimated in serum by an enzyme immuncrassay. Results: From the enrolled patients, 10 did not develop any complication; 17 developed systemic inflammatory response syndrome (SIRS); 16 developed sepsis and 11 severe sepsis. Among those who did not develop any complication, all survived. Ang-2 was increased on days 4 and 7 of follow-up in patients with SIRS. Ang-2 was highly increased upon advent of sepsis and of severe sepsis. Patients with serum levels below 15,200 pg/ml survived longer compared to those with levels above 15,200 pg/ml (p = 0.015). OR for death with serum Ang-2 above 15,200 pg/ml was 4.00 (p = 0.037). Conclusions: Serum levels of Ang-2 in multi-trauma patients are increased upon advent of septic complications and they are connected with bad prognosis. Its exact role in the process of multiple trauma remains to be defined. (C) 2008 Elsevier Ltd. All rights reserved.