Cargando…

Cell-Free DNA in Plasma and Serum Indicates Disease Severity and Prognosis in Blunt Trauma Patients

Background: Trauma is still a major cause of mortality in people < 50 years of age. Biomarkers are needed to estimate the severity of the condition and the patient outcome. Methods: Cell-free DNA (cfDNA) and further laboratory markers were determined in plasma and serum of 164 patients at time of...

Descripción completa

Detalles Bibliográficos
Autores principales: Trulson, Inga, Stahl, Juliane, Margraf, Stefan, Scholz, Martin, Hoecherl, Eduard, Wolf, Konrad, Durner, Juergen, Klawonn, Frank, Holdenrieder, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047705/
https://www.ncbi.nlm.nih.gov/pubmed/36980458
http://dx.doi.org/10.3390/diagnostics13061150
_version_ 1785013993137504256
author Trulson, Inga
Stahl, Juliane
Margraf, Stefan
Scholz, Martin
Hoecherl, Eduard
Wolf, Konrad
Durner, Juergen
Klawonn, Frank
Holdenrieder, Stefan
author_facet Trulson, Inga
Stahl, Juliane
Margraf, Stefan
Scholz, Martin
Hoecherl, Eduard
Wolf, Konrad
Durner, Juergen
Klawonn, Frank
Holdenrieder, Stefan
author_sort Trulson, Inga
collection PubMed
description Background: Trauma is still a major cause of mortality in people < 50 years of age. Biomarkers are needed to estimate the severity of the condition and the patient outcome. Methods: Cell-free DNA (cfDNA) and further laboratory markers were determined in plasma and serum of 164 patients at time of admission to the emergency room. Among them were 64 patients with severe trauma (Injury Severity Score (ISS) ≥ 16), 51 patients with moderate trauma (ISS < 16) and 49 patients with single fractures (24 femur neck and 25 ankle fractures). Disease severity was objectified by ISS and Glasgow Coma Scale (GCS). Results: cfDNA levels in plasma and serum were significantly higher in patients with severe multiple trauma (SMT) than in those with moderate trauma (p = 0.002, p = 0.003, respectively) or with single fractures (each p < 0.001). CfDNA in plasma and serum correlated very strongly with each other (R = 0.91; p < 0.001). The AUC in ROC curves for identification of SMT patients was 0.76 and 0.74 for cfDNA in plasma and serum, respectively—this was further increased to 0.84 by the combination of cfDNA and hemoglobin. Within the group of multiple trauma patients, cfDNA levels were significantly higher in more severely injured patients and patients with severe traumatic brain injury (GCS ≤ 8 versus GCS > 8). Thirteen (20.3%) of the multiple trauma patients died during the first week after trauma. Levels of cfDNA were significantly higher in non-surviving patients than in survivors (p < 0.001), reaching an AUC of 0.81 for cfDNA in both, plasma and serum, which was further increased by the combination with hemoglobin and leukocytes. Conclusions: cfDNA is valuable for estimation of trauma severity and prognosis of trauma patients.
format Online
Article
Text
id pubmed-10047705
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100477052023-03-29 Cell-Free DNA in Plasma and Serum Indicates Disease Severity and Prognosis in Blunt Trauma Patients Trulson, Inga Stahl, Juliane Margraf, Stefan Scholz, Martin Hoecherl, Eduard Wolf, Konrad Durner, Juergen Klawonn, Frank Holdenrieder, Stefan Diagnostics (Basel) Article Background: Trauma is still a major cause of mortality in people < 50 years of age. Biomarkers are needed to estimate the severity of the condition and the patient outcome. Methods: Cell-free DNA (cfDNA) and further laboratory markers were determined in plasma and serum of 164 patients at time of admission to the emergency room. Among them were 64 patients with severe trauma (Injury Severity Score (ISS) ≥ 16), 51 patients with moderate trauma (ISS < 16) and 49 patients with single fractures (24 femur neck and 25 ankle fractures). Disease severity was objectified by ISS and Glasgow Coma Scale (GCS). Results: cfDNA levels in plasma and serum were significantly higher in patients with severe multiple trauma (SMT) than in those with moderate trauma (p = 0.002, p = 0.003, respectively) or with single fractures (each p < 0.001). CfDNA in plasma and serum correlated very strongly with each other (R = 0.91; p < 0.001). The AUC in ROC curves for identification of SMT patients was 0.76 and 0.74 for cfDNA in plasma and serum, respectively—this was further increased to 0.84 by the combination of cfDNA and hemoglobin. Within the group of multiple trauma patients, cfDNA levels were significantly higher in more severely injured patients and patients with severe traumatic brain injury (GCS ≤ 8 versus GCS > 8). Thirteen (20.3%) of the multiple trauma patients died during the first week after trauma. Levels of cfDNA were significantly higher in non-surviving patients than in survivors (p < 0.001), reaching an AUC of 0.81 for cfDNA in both, plasma and serum, which was further increased by the combination with hemoglobin and leukocytes. Conclusions: cfDNA is valuable for estimation of trauma severity and prognosis of trauma patients. MDPI 2023-03-17 /pmc/articles/PMC10047705/ /pubmed/36980458 http://dx.doi.org/10.3390/diagnostics13061150 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Trulson, Inga
Stahl, Juliane
Margraf, Stefan
Scholz, Martin
Hoecherl, Eduard
Wolf, Konrad
Durner, Juergen
Klawonn, Frank
Holdenrieder, Stefan
Cell-Free DNA in Plasma and Serum Indicates Disease Severity and Prognosis in Blunt Trauma Patients
title Cell-Free DNA in Plasma and Serum Indicates Disease Severity and Prognosis in Blunt Trauma Patients
title_full Cell-Free DNA in Plasma and Serum Indicates Disease Severity and Prognosis in Blunt Trauma Patients
title_fullStr Cell-Free DNA in Plasma and Serum Indicates Disease Severity and Prognosis in Blunt Trauma Patients
title_full_unstemmed Cell-Free DNA in Plasma and Serum Indicates Disease Severity and Prognosis in Blunt Trauma Patients
title_short Cell-Free DNA in Plasma and Serum Indicates Disease Severity and Prognosis in Blunt Trauma Patients
title_sort cell-free dna in plasma and serum indicates disease severity and prognosis in blunt trauma patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047705/
https://www.ncbi.nlm.nih.gov/pubmed/36980458
http://dx.doi.org/10.3390/diagnostics13061150
work_keys_str_mv AT trulsoninga cellfreednainplasmaandserumindicatesdiseaseseverityandprognosisinblunttraumapatients
AT stahljuliane cellfreednainplasmaandserumindicatesdiseaseseverityandprognosisinblunttraumapatients
AT margrafstefan cellfreednainplasmaandserumindicatesdiseaseseverityandprognosisinblunttraumapatients
AT scholzmartin cellfreednainplasmaandserumindicatesdiseaseseverityandprognosisinblunttraumapatients
AT hoecherleduard cellfreednainplasmaandserumindicatesdiseaseseverityandprognosisinblunttraumapatients
AT wolfkonrad cellfreednainplasmaandserumindicatesdiseaseseverityandprognosisinblunttraumapatients
AT durnerjuergen cellfreednainplasmaandserumindicatesdiseaseseverityandprognosisinblunttraumapatients
AT klawonnfrank cellfreednainplasmaandserumindicatesdiseaseseverityandprognosisinblunttraumapatients
AT holdenriederstefan cellfreednainplasmaandserumindicatesdiseaseseverityandprognosisinblunttraumapatients