Abstract | BACKGROUND:
Trauma patients sustaining abdominal trauma exhibit high risk of organ failure and/or sepsis aggravating morbidity and mortality during the post-traumatic course. The present study re-evaluates L- and I-FABPs (small fatty acid binding proteins) as early biomarkers for abdominal injury (AI) in a large cohort of patients and analyzes their potential as indicators of specific organ failure and their association with sepsis and/or mortality in the post-traumatic course. METHODS: This prospective study included 134 multiply traumatized patients (ISS≥16). Fifty-nine had AI (abbreviated AI Scale, AISAbd≥3) and 75 had no AI (noAI). Twenty healthy volunteers served as controls. Plasma I- and L-FABP levels were measured at the admittance to the emergency room (d0) and up to 10 days daily (d1-d10) using ELISA. Sepsis, organ failure, multiple organ failure (MOF) and mortality were assessed. RESULTS: Median L- and I-FABP in the AI-group [258 (IQR=71-500) ng/mL and 328 (IQR=148-640) pg/mL, respectively] were higher compared to noAI-group [30 (IQR=18-50) ng/mL and 60 (IQR=40-202) pg/mL, p>0.05] on d0. Sensitivity and specificity to detect AI were 80% and 75% for L-FABP, 78% and 62% for I-FABP. Both FABPs decline with the post-traumatic course to control levels. On d0 and d1, FABPs correlate with the Sepsis-related Organ Failure Assessment (SOFA) score of the following day (d0: ρ:0.33, ρ:0.46, d1: ρ:0.48, ρ:0.35). No other correlations were found. Eight percent of all patients developed sepsis, 18% pneumonia, 4% urinary tract infection, 3% acute kidney failure and one MOF. FABPs correlated neither with Simplifed Acute Physiology Score (SAPS)-II nor to sepsis. All patients with acute kidney failure demonstrated enhanced L-FAPB levels before the increase of serum creatinine levels. CONCLUSIONS:
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Authors | Maika Voth, Sebastian Holzberger, Birgit Auner, Dirk Henrich, Ingo Marzi, Borna Relja |
Journal | Clinical chemistry and laboratory medicine
(Clin Chem Lab Med)
Vol. 53
Issue 5
Pg. 771-80
(Apr 2015)
ISSN: 1437-4331 [Electronic] Germany |
PMID | 25324448
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers
- FABP1 protein, human
- FABP2 protein, human
- Fatty Acid-Binding Proteins
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Topics |
- Abdominal Injuries
(blood, complications)
- Adult
- Aged
- Biomarkers
(blood)
- Fatty Acid-Binding Proteins
(blood)
- Female
- Humans
- Male
- Middle Aged
- Multiple Organ Failure
(complications, diagnosis, mortality)
- Prognosis
- Sepsis
(complications)
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