Early signaling of inflammation in patients following traumatic injury with accurately estimated time of injury by profiling C-reactive protein levels

• Published in: Clinica chimica acta Vol. 550; p. 117580
• Main Authors: Cohen, Neta, Feigin, Eugene, Berliner, Shlomo, Zeltser, David, Witztum, Tamar, Goldiner, Ilana, Shtark, Moshe, Shenhar-Tsarfaty, Shani, Ziv-Baran, Tomer, Matsri, Sher, Hashavia, Eyal
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.10.2023
• Subjects: C-reactive protein (CRP); Inflammatory response; Time-course analysis; Traumatic injury; C-reactive protein (CRP); Time-course analysis; Inflammatory response; Traumatic injury
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2023.117580

•C-reactive protein (CRP) is a common inflammatory biomarker in clinical medicine.•CRP is an insensitive biomarker within the first hours of a trauma event.•Accuracy of low CRP concentrations requires knowledge of inflammation onset.•Our time-course CRP analysis model is based upon precise timing of injury occurrence.•The model may refine interpretation of inflammatory responses in diverse conditions. Despite its widespread use, the precise dynamics of CRP response in clinical practice remain poorly defined. We employed a novel quadratic model to explore the time-course analysis of CRP values in trauma patients with known precise time of injury. Relevant data on all adult patients admitted to our hospital following traumatic incidents between January 1st 2010 to December 31, 2020 were retrospectively collected. Those with a documented time of injury and who underwent CRP evaluation within the first 24 h since injury were studied. Based on the findings from our annual health check-up center, we established a reference upper normal CRP value of 12.99 mg/L. Within the first 7 h after injury, the CRP levels of 8–9% of the 1545 study patients exceeded the reference threshold. The proportion of patients with CRP levels > 12.99 mg/L increased to 18.5% at 8–9 h later and rose sharply to 91.6% at 22–24 h later. Our quadratic model yielded the equation: CRP = 5.122–0.528xTime + 0.139xTime 2. It accounted for > 40% of the variance in CRP levels (R2 = 42.4%). Clear and prominent CRP elevations following atraumatic event are detected only 9–12 h following the insult. This novel finding has crucial implications for accurate CRP assessment of inflammatory responses to physical injuries.