Application value of serum high mobility group protein B1 (HMGB1) and soluble triggering receptor-1 (sTREM-1) levels in the prognostic assessment of trauma

TL;DR

This study shows that measuring HMGB1 and sTREM-1 in trauma patients' blood can help predict complications and mortality risk, guiding early clinical decisions.

Contribution

The study demonstrates that combined monitoring of HMGB1 and sTREM-1 improves prediction of trauma prognosis compared to using either marker alone.

Findings

HMGB1 and sTREM-1 levels rise with injury severity and are higher in poor-prognosis trauma patients.

Combined HMGB1 and sTREM-1 detection has higher predictive accuracy (AUC=0.891) than individual markers for complications.

Both biomarkers are independent risk factors for trauma prognosis with OR values of 3.42 and 2.98.

Abstract

This study analysed the clinical value of serum high-mobility group protein B1 (HMGB1) and soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in the prognostic assessment of trauma patients.

This prospective cohort study included 92 patients with multiple injuries admitted to our hospital between December 2022 and December 2024. The patients at admission were divided into three groups according to their Injury Severity Score: the minor injury group (n=24), the moderate injury group (n = 58), and the severe injury group (n = 10). The patients were divided into the MODS group (n=20) and the non-MODS group (n=72) on the basis of whether they had multiple organ dysfunction syndrome (MODS) after admission. The patients were divided into a death group (n = 13) and a survival group (n=79) on the basis of their outcomes within 28 days after the occurrence of trauma. Venous blood was collected from an empty stomach at 24 hours, 72 hours and 7 days after injury. The levels of serum HMGB1 and sTREM-1 were determined using an enzyme-linked immunosorbent assay (ELISA). Moreover, the injury severity score (ISS), Acute Physiology and Chronic Health Evaluation (APACHE II), complications during hospitalisation (infection, MODS, etc.) and 28-day survival of the patients were recorded.

The concentrations of serum HMGB1 and sTREM-1 in the trauma group were significantly greater than those in the control group (P< 0.01) and increased with increasing ISS. The peak levels of HMGB1 and sTREM-1 in the poor-prognosis group (death/complications) were significantly higher than those in the good-prognosis group (P< 0.001). The predictive efficacy (AU C= 0.891) of the combined detection of dual indicators for post-traumatic complications was greater than that of the single indicators (AU C= 0.812 for HMGB1 and A U C= 0.784 for sTREM-1), and the area under the ROC curve for the 28-day risk of death reached 0.927. Multivariate logistic regression analysis confirmed that both factors were independent risk factors for trauma prognosis (O R= 3.42 and O R= 2.98, respectively).

HMGB1 and sTREM-1 significantly increase in the early stage of trauma and are closely related to the severity of injury and poor prognosis. Combined dynamic monitoring can effectively predict complications and the risk of mortality, providing a crucial biomarker basis for early clinical intervention.

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