The Diagnostic Value of Plasma High Mobility Group Box 1 for Sepsis Following Severe Trauma

To investigate the diagnostic value of plasma high mobility group box 1 (HMGB1) for sepsis in patients with severe trauma.

A total of 102 patients with severe trauma were enrolled and divided into a sepsis group (57 cases) and a nonsepsis group (45 cases). The plasma levels of HMGB1, procalcitonin (PCT), and white blood cell (WBC) counts in both groups were measured, along with general clinical data. To compare the differences in these parameters between two groups, then use univariate and multivariate logistic regression analyses to identify the risk factors for sepsis in patients with severe trauma. The last, receiver operating characteristic curves was plotted to evaluate the diagnostic value of each indicator for sepsis.

Statistically significant differences were observed between the two groups in age, sex, Injury Severity Score, intensive care unit (ICU) length of stay (LOS), mechanical ventilation status, surgical intervention, and plasma levels of HMGB1, PCT, and WBC. Multivariate logistic regression analysis identified HMGB1 (odds ratio [OR] = 39.756, 95% confidence interval [CI]:3.005-525.962, P = 0.005), PCT (OR = 4.530, 95% CI: 1.327-15.461, P = 0.016), WBC (OR = 2.045,95% CI: 1.198-3.494, P = 0.009), and ICU LOS (OR = 1.307, 95% CI: 1.012-1.688, P = 0.041) as independent risk factors for sepsis in patients with severe trauma. Receiver operating characteristic curve analysis revealed that the areas under the curve for HMGB1, PCT, WBC, and ICU LOS in diagnosing sepsis were 0.935, 0.767, 0.600, and 0.808, respectively. The combined diagnostic areas under the curve of all four parameters were 0.988, with a sensitivity of 94.7% and specificity of 93.3%.

Plasma HMGB1, PCT, WBC, and ICU LOS have diagnostic value for sepsis in patients with severe trauma, and their combined application yields higher diagnostic accuracy.