Abstract

On CBC examined immediately after multiple trauma, surgeons and emergency physicians couldn``t get much informations about injury severity and degree of injury. In other words, the leukocytosis didn``t reveal injury severity and hemoglobin/hematocrit level done immediately after trauma was normal range althought internal bleeding was continued. But band form count in leukocytes reveals close relation with injury severity and mortality. One hundred twenty two patients were studied prospectively to assess the injury severtiy and mortality according to band form(%) on CBC. Among them, 25 patients was re-examinated to calculate the immune cells(lymphocyte, T cell, Helper T cell(Th) and cytotoxicsuppressor T cell(Tc/s) and Th: Tc/s ratio). The patients(n=17) with band form above 3% in differential count of CBC revealed 27.0 ± 10.25 in Injury Severity Score(ISS), and group with below 3% was 14.8±8.76(P<0.00l). The mortality of patients with band form above 3% was three times higher than patients with below 3%. The Th : Tc/s ratio was 0.98: 1 in patients with band23%(n=6) and 1.27 in band<3%(n=19). In summary, the patients with band forms above 3% on CBC immediately after trauma were severly injured and immune function was much decreased. So emergency physicians must re-evaluate the injured patients if band form was above 3% in differential count of CBC.