Clinical Study Of The Relationship Between Soluble Triggering Receptor Expressed On Myeloid Cells-1 And Severe Thoracic Trauma

Objective: To investigate the change and role of plasma sTREM-1after severe thoracic trauma,and to analyze its value in evaluation injury severity and diagnosis traumatic sepsis at early stage.Methods: A prospective cohort study was conducted to analyze the severe thoracic trauma patients in Chongqing Emergency Medical Center and Army Medical University Daping Hospital from August 2016 to May2017.Peripheral blood samples of patients were collected at days 1,3,5,7,and 14.The plasma s TREM-1 concentration was detected by ELISA.Changes of level were paid attention after trauma,and the relationship between sTREM-1 and ISS was analyzed.AUC was used to evaluate the diagnostic value of plasma sTREM-1 in traumatic sepsis.Results:(1)After trauma,plasma sTREM-1 level increased significantly on D1(P < 0.001)and maintained high levels within 14 days.However,there was no time-dependent change in 2 weeks.(2)Compared with ISS < 20 patients,the plasma sTREM-1 level increased significantly in ISS ? 20 patients(all P values < 0.05)at each day.There was a slightly positive correlation between plasma sTREM-1 leveland ISS(D5 P = 0.05;D1,D3,D7,and D14 P < 0.05).(3)Compared with the non-infection group,the plasma s TREM-1level was higher in the infection group,and the difference was significant in all days(D1,D5 to D14 P < 0.01;D3 P < 0.05).(4)Compared with the non-sepsis group,the plasma sTREM-1 level was significantly higher in sepsis group(D5,D14 P < 0.001;D1,D3,D7 P< 0.05).The AUCs of level of plasma sTREM-1 level in traumatic sepsis were between 0.7 to 0.9 on D1 and D5 to D14.But was 0.697 on D3.(5)Compared with the traumatic survival group,the plasma s TREM-1level was significantly higher in the traumatic death group(D1 P < 0.01;D3 P < 0.05).Conclusion:(1)There is a positively correlated between plasma sTREM-1 level and ISS in patients with severe thoracic trauma.The sTREM-1 can be used to predict the severity of injury in early stage after trauma.(2)Plasma s TREM-1 level has a potential value in early diagnosis of traumatic sepsis.The accuracy of diagnosis is moderate degree when is applied alone.(3)Increased plasma sTREM-1 level in patients with severe thoracic trauma may suggest a high risk of death.