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- Title
Development of a biomarker prediction model for post-trauma multiple organ failure/dysfunction syndrome based on the blood transcriptome.
- Authors
Duran, Ivan; Banerjee, Ankita; Flaherty, Patrick J.; Que, Yok-Ai; Ryan, Colleen M.; Rahme, Laurence G.; Tsurumi, Amy
- Abstract
Background: Multiple organ failure/dysfunction syndrome (MOF/MODS) is a major cause of mortality and morbidity among severe trauma patients. Current clinical practices entail monitoring physiological measurements and applying clinical score systems to diagnose its onset. Instead, we aimed to develop an early prediction model for MOF outcome evaluated soon after traumatic injury by performing machine learning analysis of genome-wide transcriptome data from blood samples drawn within 24 h of traumatic injury. We then compared its performance to baseline injury severity scores and detection of infections. Methods: Buffy coat transcriptome and linked clinical datasets from blunt trauma patients from the Inflammation and the Host Response to Injury Study ("Glue Grant") multi-center cohort were used. According to the inclusion/exclusion criteria, 141 adult (age ≥ 16 years old) blunt trauma patients (excluding penetrating) with early buffy coat (≤ 24 h since trauma injury) samples were analyzed, with 58 MOF-cases and 83 non-cases. We applied the Least Absolute Shrinkage and Selection Operator (LASSO) and eXtreme Gradient Boosting (XGBoost) algorithms to select features and develop models for MOF early outcome prediction. Results: The LASSO model included 18 transcripts (AUROC [95% CI]: 0.938 [0.890–0.987] (training) and 0.833 [0.699–0.967] (test)), and the XGBoost model included 41 transcripts (0.999 [0.997–1.000] (training) and 0.907 [0.816–0.998] (test)). There were 16 overlapping transcripts comparing the two panels (0.935 [0.884–0.985] (training) and 0.836 [0.703–0.968] (test)). The biomarker models notably outperformed models based on injury severity scores and sex, which we found to be significantly associated with MOF (APACHEII + sex—0.649 [0.537–0.762] (training) and 0.493 [0.301–0.685] (test); ISS + sex—0.630 [0.516–0.744] (training) and 0.482 [0.293–0.670] (test); NISS + sex—0.651 [0.540–0.763] (training) and 0.525 [0.335–0.714] (test)). Conclusions: The accurate assessment of MOF from blood samples immediately after trauma is expected to aid in improving clinical decision-making and may contribute to reduced morbidity, mortality and healthcare costs. Moreover, understanding the molecular mechanisms involving the transcripts identified as important for MOF prediction may eventually aid in developing novel interventions.
- Subjects
MORTALITY prevention; WOUNDS &; injuries; RISK assessment; PREDICTION models; PATIENTS; RECEIVER operating characteristic curves; RESEARCH funding; MULTIPLE organ failure; MULTIPLE regression analysis; FUNCTIONAL assessment; SEVERITY of illness index; INFECTION; EMERGENCY medical services; DECISION making in clinical medicine; DESCRIPTIVE statistics; MULTIVARIATE analysis; LONGITUDINAL method; DISEASES; GENE expression profiling; RESEARCH; COMPARATIVE studies; CONFIDENCE intervals; DATA analysis software; MACHINE learning; BIOMARKERS; ALGORITHMS; MEDICAL care costs; SENSITIVITY &; specificity (Statistics); DISEASE risk factors
- Publication
Annals of Intensive Care, 2024, Vol 14, Issue 1, p1
- ISSN
2110-5820
- Publication type
Article
- DOI
10.1186/s13613-024-01364-5