Development of a Genomic Metric that can be Rapidly Used to Predict Clinical Outcome in Severely Injured Trauma Patients

Abstract

Objective-Many patients following severe trauma have complicated recoveries due to the development of organ injury. Physiological and anatomical prognosticators have had limited success in predicting clinical trajectories. We report on the development and retrospective validation of a simple genomic composite score that can be rapidly used to predict clinical outcomes. Design-Retrospective cohort study Setting-Multi-institution level 1 trauma centers Patients-Data was collected from 167 severely traumatized (ISS >15) adult (18-55 yo) patientsMethods-Microarray-derived genomic data obtained from 167 severely traumatized patients over 28 days were assessed for differences in mRNA abundance between individuals with different clinical trajectories. Once a set of genes was identified based on differences in expression over the entire study period, mRNA abundance from these subjects obtained in the first 24 hours was analyzed in a blinded fashion using a rapid multiplex platform, and genomic data reduced to a single metric.Results-From the existing genomic data set, we identified 63 genes whose leukocyte expression differed between an uncomplicated and complicated clinical outcome over 28 days.