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

Objective: This study analyzed the clinical value of serum high mobility group protein B1 (HMGB1) and soluble triggering receptor 1 for myeloid cells (sTREM-1) in the prognostic assessment of trauma patients. Methods: In this prospective cohort study, 92 patients with multiple injuries admitted to our hospital from December 2022 to December 2024 were selected. The patients at admission were divided into three groups according to their injury severity score: the minor injury group (n=24), the severe 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 detected via enzyme-linked immunosorbent assay (ELISA). Moreover, the injury severity score (ISS), Acute Physiology and Chronic Health Evaluation (APACHE II), complications during hospitalization (infection, MODS, etc.) and 28-day survival of the patients were recorded. Results: 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 greater than those in the good prognosis group (P<0.001). The predictive efficacy (AUC=0.891) of the combined detection of dual indicators for posttraumatic complications was greater than that of the single indicators (AUC=0.812 for HMGB1, AUC=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 (OR = 3.42 and OR = 2.98, respectively). Conclusion: 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 death, providing an important biomarker basis for early clinical intervention.