title: Plasma DNA as a prognostic marker in trauma patients.
abstract: BACKGROUND
  Recently, much interest has developed in the potential use of plasma DNA as a diagnostic and monitoring tool. We hypothesized that plasma DNA is increased in patients with trauma and may be prognostic in such patients.
  
  
  METHODS
  We studied 84 patients who had sustained an acute blunt traumatic injury. We measured plasma DNA by a real-time quantitative PCR assay for the beta-globin gene. Blood samples were collected at a median time of 60 min following injury. Blood samples were also obtained from 27 control subjects.
  
  
  RESULTS
  The median plasma DNA concentrations in the control, minor/moderate trauma (Injury Severity Score <16; n = 47), and major trauma (Injury Severity Score > or =16; n = 37) groups were 3154 kilogenome-equivalents/L, 13 818 kilogenome-equivalents/L, and 181 303 kilogenome-equivalents/L, respectively. Plasma DNA concentrations in patients with adverse outcomes, including acute lung injury, acute respiratory distress syndrome, and death, had 11. 6- to 12-fold higher plasma DNA concentrations than those who did not develop these complications. At a cutoff of 232 719 kilogenome-equivalents/L, the sensitivities of plasma DNA analysis for the prediction of acute lung injury, acute respiratory distress syndrome, and death were 100% (95% confidence interval, 100-100%), 100% (95% confidence interval, 100-100%), and 78% (95% confidence interval, 40-97%), respectively. The respective specificities were 81% (95% confidence interval, 71-89%), 80% (95% confidence interval, 70-88%), and 82% (95% confidence interval, 71-90%).
  
  
  CONCLUSIONS
  Plasma DNA is increased after trauma and may be a potentially valuable prognostic marker for these patients.
authors.affiliation: Department of Chemical Pathology and Accident & Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR. loym@cuhk.edu.hk
authors.forename: Y M
authors.initials: YM
authors.lastname: Lo
authors.forename: T H
authors.initials: TH
authors.lastname: Rainer
authors.forename: L Y
authors.initials: LY
authors.lastname: Chan
authors.forename: N M
authors.initials: NM
authors.lastname: Hjelm
authors.forename: R A
authors.initials: RA
authors.lastname: Cocks
mesh_terms: D015415:Biomarkers / Q000097:blood; D004247:DNA / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014949:Wounds, Nonpenetrating / Q000097:blood / Q000235:genetics* / Q000401:mortality
chemical_list: D015415:Biomarkers; D004247:DNA