Serum levels of NLRP3 and HMGB-1 are associated with the prognosis of patients with severe blunt abdominal trauma

Kuanxue Sun,Hongwei Xia

doi:10.6061/clinics/2019/e729

Abstract

OBJECTIVES:To investigate the relationship between the serum levels of NLRP3 and HMGB-1 and the prognosis of patients with severe blunt abdominal trauma.METHODS:In total, 299 patients were included in the current study from July 2014 to December 2015. All patients were divided into the mild/moderate blunt abdominal trauma group and the severe blunt abdominal trauma group according to their injury severity scores. Serum levels of NLRP3 and HMGB-1 were measured upon admission (0 h) and at 12 h, 24 h, 48 h, 72 h and 7 days after admission.RESULTS:Compared with the healthy controls, both the mild/moderate and severe blunt abdominal trauma groups had higher serum levels of NLRP3 and HMGB-1 at admission. At all points, the serum levels of NLRP3 and HMGB-1 were significantly higher in the severe group than in the mild/moderate group. The serum levels of both NLRP3 and HMGB-1 were significantly higher in the deceased patients than in the living patients. The Kaplan-Meier curve showed that compared with patients with higher levels of NLRP3 or HMGB-1, those with lower levels had longer survival times. The serum levels of both NLRP3 and HMGB-1 were independent risk factors for 6-month mortality in severe blunt abdominal trauma patients.CONCLUSION:The serum levels of NLRP3 and HMGB-1 were significantly elevated in severe blunt abdominal trauma patients, and the serum levels of both NLRP3 and HMGB-1 were correlated with 6-month mortality in severe blunt abdominal trauma patients.

Highlights

Trauma is the leading cause of death among people younger than 45 years, and it is the fourth overall cause of death regardless of age; trauma imposes a substantial economic burden on health care systems [1,2]
The results showed that at all time points, the serum levels of NLRP3 and High mobility group box-1 (HMGB-1) were significantly higher in the deceased patients than in the living patients, suggesting that NLRP3 and HMGB-1 levels might be associated with death in severe blunt abdominal trauma (BAT) patients (Figure 2)
HMGB-1 and NLRP3 are 2 newly identified factors that may be associated with the prognosis of trauma patients

Summary

Introduction

Trauma is the leading cause of death among people younger than 45 years, and it is the fourth overall cause of death regardless of age; trauma imposes a substantial economic burden on health care systems [1,2]. More than 180,000 people died of trauma in 2007, and almost one-third of all emergency department visits are due to trauma every year [3]. The most common causes of blunt abdominal trauma (BAT) are traffic accidents, falls from a height, assaults, and sports accidents [6,7]. In the treatment of BAT, any delay in the identification of intra-abdominal injuries (IAI) may lead.

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