I-FABP and L-FABP are early markers for abdominal injury with limited prognostic value for secondary organ failures in the post-traumatic course

Abstract

AbstractTrauma patients sustaining abdominal trauma exhibit high risk of organ failure and/or sepsis aggravating morbidity and mortality during the post-traumatic course. The present study re-evaluates L- and I-FABPs (small fatty acid binding proteins) as early biomarkers for abdominal injury (AI) in a large cohort of patients and analyzes their potential as indicators of specific organ failure and their association with sepsis and/or mortality in the post-traumatic course.This prospective study included 134 multiply traumatized patients (ISS≥16). Fifty-nine had AI (abbreviated AI Scale, AISMedian L- and I-FABP in the AI-group [258 (IQR=71–500) ng/mL and 328 (IQR=148–640) pg/mL, respectively] were higher compared to noAI-group [30 (IQR=18–50) ng/mL and 60 (IQR=40–202) pg/mL, p>0.05] on d0. Sensitivity and specificity to detect AI were 80% and 75% for L-FABP, 78% and 62% for I-FABP. Both FABPs decline with the post-traumatic course to control levels. On d0 and d1, FABPs correlate with the Sepsis-related Organ Failure Assessment (SOFA) score of the following day (d0:Our results confirm the potential of L- and I-FABP to indicate abdominal injuries initially after trauma. Except L-FABP as indicator of acute kidney failure both FABPs have to be further evaluated as predictors for other organ failures, sepsis and/or mortality.