ArticleCritical care (London, England)2015
Improvement of prognostic performance in severely injured patients by integrated clinico-transcriptomics: a translational approach.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 24 citations in OpenAlex.
- Remote Pancreatic Response to Severe Polytrauma Correlates With Clinical Outcome.United European gastroenterology journal · 2026Article
- Clinical utility of the Platelet-to-neutrophil ratio in differentiating sepsis from neonatal pneumonia: an observational study.Annals of medicine · 2025Observational
- Sepsis after trauma-evolving paradigms in stress biology and host response failure.Burns & trauma · 2025Review
- The role of big data management, data registries, and machine learning algorithms for optimizing safe definitive surgery in trauma: a review.Patient safety in surgery · 2024Review
- How do sphingosine-1-phosphate affect immune cells to resolve inflammation?Frontiers in immunology · 2024Review
- Hemorrhagic Shock Induces a Rapid Transcriptomic Shift of the Immune Balance in Leukocytes after Experimental Multiple Injury.Mediators of inflammation · 2021Article
- Validation of reference genes for expression analysis in a murine trauma model combining traumatic brain injury and femoral fracture.Scientific reports · 2020Article
- Interleukin-33 (IL-33) as a Diagnostic and Prognostic Factor in Traumatic Brain Injury.Emergency medicine international · 2020Review
- Machine learning for the detection of early immunological markers as predictors of multi-organ dysfunction.Scientific data · 2019Article
- Circulating growth/differentiation factor 15 is associated with human CD56EBioMedicine · 2019Article
- Lipid metabolism impairment in patients with sepsis secondary to hospital acquired pneumonia, a proteomic analysis.Clinical proteomics · 2019Article
- Targeting Complement Pathways in Polytrauma- and Sepsis-Induced Multiple-Organ Dysfunction.Frontiers in immunology · 2019Review
- Complement After Trauma: Suturing Innate and Adaptive Immunity.Frontiers in immunology · 2018Review
- Auxiliary activation of the complement system and its importance for the pathophysiology of clinical conditions.Seminars in immunopathology · 2018Review
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSevere trauma triggers a systemic inflammatory response that contributes to secondary complications, such as nosocomial infections, sepsis or multi-organ failure. The present study was aimed to identify markers predicting complications and an adverse outcome of severely injured patients by an integrated clinico-transcriptomic approach.
methodsIn a prospective study, RNA samples from circulating leukocytes from severely injured patients (injury severity score ≥ 17 points; n = 104) admitted to a Level I Trauma Center were analyzed for dynamic changes in gene expression over a period of 21 days by quantitative RT-PCR. Transcriptomic candidates were selected based on whole genome screening of a representative discovery set (n = 10 patients) or known mechanisms of the immune response, including mediators of inflammation (IL-8, IL-10, TNF-α, MIF, C5, CD59, SPHK1), danger signaling (HMGB1, TLR2, CD14, IL-33, IL-1RL1), and components of the heme degradation pathway (HP, CD163, HMOX1, BLVRA, BLVRB). Clinical markers comprised standard physiological and laboratory parameters and scoring systems routinely determined in trauma patients.
resultsLeukocytes, thrombocytes and the expression of sphingosine kinase-1 (SPHK1), complement C5, and haptoglobin (HP) have been identified as markers with the best performance. Leukocytes showed a biphasic course with peaks on day 0 and day 11 after trauma, and patients with sepsis exhibited significantly higher leukocyte levels. Thrombocyte numbers showed a typical profile with initial thrombopenia and robust thrombocytosis in week 3 after trauma, ranging 2- to 3-fold above the upper normal value. 'Relative thrombocytopenia' was associated with multi-organ dysfunction, the development of sepsis, and mortality, the latter of which could be predicted within 3 days prior to the time point of death. SPHK1 expression at the day of admission indicated mortality with excellent performance. C5-expression on day 1 after trauma correlated with an increased risk for the development of nosocomial infections during the later course, while HP was found to be a marker for the development of sepsis.
conclusionsThe combination of clinical and transcriptomic markers improves the prognostic performance and may represent a useful tool for individual risk stratification in trauma patients.
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