Blood Biomarkers Predict Patient Recovery from Traumatic Injury

Researchers at the University of Colorado Anschutz have developed a method to predict how patients with traumatic injury will recover, the amount of time they will spend in intensive care, and the likelihood of complications such as organ failure by analyzing blood biomarkers. Published today in Science Translational Medicine, their findings provide unprecedented insights into why patients with similar injuries can sometimes have vastly different outcomes and recovery paths.

“This is precision medicine for trauma,” said Kirk Hansen, PhD, professor of biochemistry at CU Anschutz and a senior author of the study. “By combining proteomics and metabolomics data, we can not only predict outcomes more accurately than traditional methods, but also start to understand the biology that drives those outcomes.”

Patients with traumatic injury admitted to the intensive care unit (ICU) are typically assessed based on the severity of their injury, demographics and preexisting conditions. However, these factors cannot accurately predict how well the patient will evolve over time or how they will respond to bleeding control agents used to reverse shock and resuscitate them. 

“Two patients often arrive in the ER with nearly identical injuries but go on to have widely divergent outcomes despite similar care,” said Mitchell Cohen, MD, professor of surgery at CU Anschutz and co-senior author of the study. “This occurs because their biologic response to injury and treatment is different, and our novel approach and modeling allow us to see those differences in real time, which could fundamentally change our practice.”

The study looked at proteomics and metabolomics data from 118 patients with severe injury and 97 healthy controls. More than 1,400 biomarkers were analyzed across 11 time points since ICU admission, allowing the researchers to identify several endotypes linked to distinct clinical outcomes.   

For instance, patients who initially presented elevated levels of proteasome activity were more likely to experience lung failure, while elevated superoxide formation was linked to higher rates of acute lung injury. Biomarkers of increased hypoxia and hydrolase activity were linked to longer ICU stays and higher chances of death. 

These results were then validated in an independent cohort of 333 traumatic injury patients, where the model showed 86% accuracy when predicting outcomes. In comparison, predictions based on the observation of conventional risk factors showed 57% accuracy. 

Going forward, the researchers plan to develop a molecular profiling approach that enables fast point-of-care testing in emergency and military settings, helping doctors make more precise, personalized decisions based on each patient’s unique profile. 

“This is precision metabolic health in action, validated in an independent cohort and ready for clinical use today,” said Angelo D’Alessandro, PhD, professor of biochemistry at CU Anschutz. “The same science that can forecast a trauma patient’s outcome days in advance also powers tools to understand how the body responds to extreme endurance and to safeguard the quality of donated blood. The future of personalized health isn’t decades away—it’s here now, for those with the vision to put it into practice.”