Identifying biomarkers distinguishing sepsis after trauma from trauma-induced SIRS based on metabolomics data: a retrospective study

Sepsis after trauma and trauma-induced SIRS have similar symptoms, making their differentiation challenging. Therefore, biomarkers are needed to differentiate between sepsis after trauma and trauma-induced SIRS. We hypothesized that sepsis following trauma induces distinct alterations in blood metabolism compared to trauma-induced SIRS and sought to identify metabolite biomarkers in blood that could differentiate between the two. In this retrospective study, the existing blood metabolomics data from 60 patients without trauma-induced SIRS, 40 patients with trauma-induced SIRS, and 50 non-trauma control cases were analyzed. Among 40 traumatic patients with SIRS, 16 developed sepsis (SDS group), 24 did not develop sepsis (SDDS group) within the subsequent two-week period after trauma. A pairwise comparison between SDS group and SDDS group was used to screen the differential metabolites as biomarkers distinguishing sepsis after trauma from trauma-induced SIRS. Using partial least‑squares discriminant analysis, we demonstrated that SDS group was metabolically distinct from the SDDS group. A total of 37 differential metabolites were found between SDS group and SDDS group. We selected 5 most significantly different metabolites between SDS and SDDS groups as biomarkers to discriminate sepsis after trauma from trauma-induced SIRS, which were 7-alpha-carboxy-17-alpha-carboxyethylandrostan lactone phenyl ester, docosatrienoic acid, SM 8:1;2O/26:1, SM 34:2;2O, and N1-[1-(3-isopropenylphenyl)-1-methylethyl]-3-oxobutanamide. Our study has identified the potential of these biomarkers for differentiating sepsis after trauma from trauma-induced SIRS. This not only provides a new approach for the early diagnosis of sepsis after trauma but also lays a solid foundation for further research based on targeted metabolomics, which may lead to the development of more effective treatment strategies in the future.