Diurnal variation of leukocytosis and its prognostic significance in head trauma in local population

Abstract

Objectives: A. To study the predictive value of diurnal variation of leukocytosis in minor, moderate and severe head trauma. B. To study the relationship between leukocytosis with Glass Coma Scor (GCS). C. To study the relationship between leukocytosis and computed tomography scan. Study design: Prospective and analytical study. Place and duration of study: Department of Physiology, Basic Medical Science Institute (B.M.S.I) in Accident and Emergency, ICU of Neurosurgery Department(ward-16) Jinnah Post graduation Medical College (JPMC) Karachi Pakistan from August 2009 to August 2010. Methodology: 90 patients of head trauma were included, after taking complete history from the conscious patients and from the attendants of unconscious patients. Glass Coma Score were observed immediately and blood sample was taken for laboratory findings and manual observations especially for white cell count with hemocytometer (Neubaur chamber), peripheral smear were prepared at the spot for differential leukocyte count within the time. Results: 90 patients of head trauma of age 16 to 70 years were included of either sex. Statistically the mean leukocyte count revealed that significantly higher in severe head trauma as compared to minor and moderate (P<0.001) and significantly higher as compared moderate to minor (P<0.001). Correlation of total leukocyte count with GCS that show highly significant correlation between two (P<0.01). The significant correlation between differential leukocyte count with GCS with P<0.05. Significant correlation of TLC with (CT) scan with P<0.01. 90 Patients divided into age groups age of 21-30 year, 24 (26.7%) followed by 31-40 year (22.2%) age 39.8+6.5 male were 75 (83%) and female (17%). Conclusion: On admission, white blood cells (WBC) count exceeding 19000/mm3 has a predictive as well as prognostic value for poor Glasgow coma scale (GCS) and serves as a significant parameter of severity of injury and predicator neurological out coma in patients with severe head injury in local population.