Relationship between early neuroendocrine response and severity of war injury according to the Red Cross Classification.

The hypothesis that neuroendocrine response to military gunshot/missile (MG/M) wounds reflect the severity and type of wounds given by the Red Cross Wound Classification (RCWC), has been tested on 82 casualties of war in former Yugoslavia. Adrenaline (A), noradrenaline (N), Cortisol, triiodothyronine (T3), testosterone (TES) and prolactin (PRL) levels have been measured in blood samples taken on admission (2-18 hr after wounding) at Military Medical Academy. Neuroendocrine response to MG/M wounds has clearly reflected severity but not the type of wounds and it has been bidirectional, i.e. A, NA and cortisol levels positively related to, while T3 and TES levels were negatively related to severity of MG/M wounds. With regard to high compatibility between RCWC and Injury severity score (ISS) and the fact that magnitude of the neuroendocrine response is related to severity given by RCWC we have concluded that the RCWC is a good method of grading wound severity on the battlefield.