Leukocyte profile of adult Nigerian subjects with acute musculoskeletal trauma

BACKGROUND: Leukocyte levels are evidently useful in trauma assessment, prognostication and management.1 Leukocytosis is a known physiologic response to trauma 2 but suggested to be absent among Africans origin3. The aim of present study is to investigate the existence of leukocytosis among adult Nigerians who sustain acute musculoskeletal trauma, and also assess its prognostic value in management. METHODS: A calculated sample size of 223 subjects participated following informed consent while 50 apparently healthy adult Nigerian volunteers served as control. Data obtained included age, sex, duration of hospitalization and leukocyte counts using improved Neuabauer chamber while differential count was done on stained thin film.RESULTS: Analyzed results expressed as mean + SDM show significant male dominance (p < 0.05) among the acutely traumatized subjects with majority (70%) aged between 20 and 49 years. The mean total white blood cell count was 8184.96 + 201.087 cells/mm3, significantly higher than mean for the control group (4922.00+1282.264 cells/mm3) at p < 0.05. The mean values for neutrophil and lymphocytes also show significant neutrophilia and lymphocytopaenia among the test population (p < 0.05). Pearson's correlation test for duration of hospitalization was positive for higher levels of total White Blood Cell count, with strong positive correlation between the levels of neutrophil and total White Blood Cell count suggesting the source of the observed leukocytosis. CONCLUSION: Thus adult Nigerians exhibit post-traumatic neutrophilic leukocytosis contrary to some widely accepted postulations. The post-traumatic neutrophilia exhibit an inverse relationship with observed lymphocytopaenia. This can be expressed as a ratio called Neutrophil Lymphocyte Stress Factor (NLSF) and used in trauma management and prognosis determination.KEYWORDS: Leukocyte profile, Adult Nigerians, Acute musculoskeletal traum