HMGB-1 as a predictor of major bleeding requiring activation of a massive transfusion protocol in severe trauma

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00843989%3A_____%2F25%3AE0111496" target="_blank" >RIV/00843989:_____/25:E0111496 - isvavai.cz</a>

Alternative codes found

RIV/61988987:17110/25:A2603A8S RIV/61989100:27240/25:10259611

Result on the web

<a href="https://www.nature.com/articles/s41598-025-89139-1" target="_blank" >https://www.nature.com/articles/s41598-025-89139-1</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1038/s41598-025-89139-1" target="_blank" >10.1038/s41598-025-89139-1</a>

Result language

angličtina

Original language name

HMGB-1 as a predictor of major bleeding requiring activation of a massive transfusion protocol in severe trauma

Original language description

Massive bleeding causes approximately 50% of deaths in patients with major trauma. Most patients die within 6 h of injury, which is preventable in at least 10% of cases. For these patients, early activation of the massive transfusion protocol (MTP) is a critical survival factor. With severe trauma, high-mobility group box 1 (HMGB-1, i.e., amphoterin) is released into the blood, and its levels correlate with the development of a systemic inflammatory response, traumatic coagulopathy, and fibrinolysis. Previous work has shown that higher levels of HMGB-1 are associated with a higher use of red blood cell transfusions. We conducted a retrospective analysis of previous prospective single-center study to assess the value of admission HMGB-1 levels in predicting activation of MTP in the emergency department. From July 11, 2019, to April 23, 2022, a total of 104 consecutive adult patients with severe trauma (injury severity score > 16) were enrolled. A blood sample was taken at admission, and HMGB-1 was measured. MTP activation in the emergency department was recorded in the study documentation. The total amount of blood products and fibrinogen administered to patients within 6 h of admission was monitored. Among those patients with massive bleeding requiring MTP activation, we found significantly higher levels of HMGB-1 compared to patients without MTP activation (median [interquartile range]: 84.3 µg/L [34.2-145.9] vs. 21.1 µg/L [15.7-30.4]; p < 0.001). HMGB-1 level showed good performance in predicting MTP activation, with an area under the receiver operating characteristic curve of 0.84 (95% CI 0.75-0.93) and a cut-off value of 30.55 µg/L. HMGB-1 levels correlated significantly with the number of red blood cell units (rs [95% CI] 0.46 [0.28-0.61]; p < 0.001), units of fresh frozen plasma (rs 0.46 [0.27-0.61]; p < 0.001), platelets (rs 0.48 [0.30-0.62]; p < 0.001), and fibrinogen (rs 0.48 [0.32-0.62]; p < 0.001) administered in the first 6 h after hospital admission....

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30221 - Critical care medicine and Emergency medicine

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Scientific reports

ISSN

2045-2322

e-ISSN

2045-2322

Volume of the periodical

15

Issue of the periodical within the volume

1

Country of publishing house

US - UNITED STATES

Number of pages

12

Pages from-to

1-12

UT code for WoS article

001416556400018

EID of the result in the Scopus database

2-s2.0-85218178410