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Key laboratory changes in severe trauma, a different pattern for each clinical phenotype.

Adrián Marcos-Morales1, Jesús Abelardo Barea Mendoza2, Marcos Valiente Fernández2

  • 1Intensive Care Department, Trauma and Emergency Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Fundación de Investigación Biomédica, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain.

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|June 4, 2025
PubMed
Summary
This summary is machine-generated.

Laboratory parameters evolve differently in severe trauma patients based on their phenotype. Specific markers like neutrophil-to-lymphocyte ratio and hypernatremia can indicate neurological damage in hemodynamically stable patients.

Keywords:
BiomarcadoresBiomarkersFenotiposLaboratorioLaboratoryNeutrophil-to-lymphocyte ratioPhenotypesRatio neutrófilo-linfocitoSevere traumaTrauma grave

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Area of Science:

  • Trauma research
  • Clinical pathology
  • Intensive care medicine

Background:

  • Severe trauma necessitates understanding patient phenotypes for tailored care.
  • Conventional laboratory parameters offer insights into trauma severity and evolution.
  • Differentiating trauma phenotypes is crucial for predicting outcomes.

Purpose of the Study:

  • To compare the evolution of laboratory parameters across three distinct severe trauma phenotypes.
  • To identify specific laboratory markers associated with different trauma patient groups.
  • To assess the utility of laboratory parameters in evaluating initial severity and predicting neurological damage.

Main Methods:

  • Observational study of a prospectively collected cohort of severe trauma patients (Abbreviated Injury Scale ≥ 3).
  • Patients categorized into three phenotypes based on hemodynamic status and Glasgow Coma Scale (GCS).
  • Laboratory parameters (blood count, biochemistry, coagulation, blood gas) analyzed up to 96 hours post-injury.

Main Results:

  • Initial leukocytosis and hyperglycemia were observed in all groups.
  • Hemodynamically stable patients with GCS < 14 showed elevated neutrophil-to-lymphocyte ratio (NLR) and hypernatremia at 24 hours.
  • Hemodynamically unstable patients presented with lactic acidosis, coagulopathy, and decreased hemoglobin, albumin, and calcium, with worse outcomes in the prematurely deceased.

Conclusions:

  • Laboratory parameter evolution varies significantly based on severe trauma phenotype.
  • These evolving parameters complement initial severity assessments.
  • In hemodynamically stable patients, specific laboratory markers serve as early warnings for potential neurological damage.