Cytokine Biomarker Phenotype for Early Prediction and Triage of Sepsis in Blunt Trauma Patients

Background: The study aimed to establish the profiles of cytokines in trauma patients to characterize the nature of the immune responses to sepsis, which might enable early prediction and individualized treatments to be developed and targeted.Methods: A 15-plex human cytokine magnetic bead assay system was used to measure analytes in citrated plasma samples. Analysis of these cytokine kinetics was performed on 40 patients with severe blunt trauma admitted to our trauma center between March 2016 and February 2017 with Injury Severity Score (ISS) more than 20 with regard to sepsis (Sepsis-3) over a 14-day time course.Results: In total, six cytokines changed in trauma patients between the different timepoints at day 1, 3, 5, 7, and 14. Additionally, IL-6, IL-10, IL-15, MDC, GRO, sCD40L, G-CSF, and FGF-2 significantly distinguished between sepsis and nonsepsis at day 3 and afterward with an area under the curve of up to 0.90 when the eight biomarkers (P < 0.001) were combined. Event-related analysis demonstrated 1.5- to 4-fold serum level changes for these cytokines within 72 hours before clinically apparent sepsis. Conclusion: Cytokine profiles demonstrate high discriminatory ability to timely identify evolving traumatic sepsis. These abrupt changes allow sepsis detection up to 72 hours before clinically overt deterioration. Measurement of these cytokines might enable future studies to better predict, diagnose, and characterize traumatic sepsis, as well as confer the potential for physicians to timely initiate treatment with reduced mortality and costs.Trial registration: Clinicaltrials, NCT01713205. Registered 22 October 2012, https://register.clinicaltrials.gov/NCT01713205