Relationship Between Release of β-Endorphin, Cortisol, and Trauma Severity in Children With Blunt Torso and Extremity Trauma

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Abstract

Purpose:

To determine the levels of β-endorphin and cortisol in children with multiple injuries and to determine whether there is any difference between and compare the severity of trauma and β-endorphin and cortisol release as calculated using Pediatric Trauma Score (PTS).

Methods:

During a 10-month period, 80 children with multiple injuries admitted to a University Hospital's Pediatric Surgery Department were studied. Blood samples were obtained immediately at admission and a PTS of each patient was calculated. The correlation between PTS and hormonal values were searched. The children were classified into two groups according to their PTS. Group 1 had PTS >8 and group 2 had PTS ≤8. The two groups were also compared with respect to their β-endorphin and cortisol values.

Results:

There was a linear correlation between β-endorphin and cortisol values and the injury severity. The levels were higher in the patients with more severe injuries. There were 60 patients in group 1 and 20 patients in group 2. Their ages were 9.2 ± 4.1 and 9.7 ± 4.2 years, respectively (p > 0.05). The mean PTS for group 1 patients was 11 ± 0.8 and for group 2 patients was 7.4 ± 1.2 (p < 0.001). The mean plasma β-endorphin concentrations were 124.4 ± 114.4 pg/mL in group 1 patients and 261.6 ± 231.2 pg/mL in group 2 (p < 0.001). The respective plasma cortisol concentrations in the two groups were 22.5 ± 10.3 μg/dL and 30.8 ± 17.2 μg/dL (p < 0.05), respectively.

Conclusions:

The results of this study show that the plasma β-endorphin and cortisol levels are elevated in children after blunt trauma and the degree of elevation is related to the injury severity.

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