{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:38:45Z","timestamp":1787027925507,"version":"build-2736575974"},"reference-count":55,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Leukocare AG"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Trauma is still a major cause of mortality in people &lt; 50 years of age. Biomarkers are needed to estimate the severity of the condition and the patient outcome. Methods: Cell-free DNA (cfDNA) and further laboratory markers were determined in plasma and serum of 164 patients at time of admission to the emergency room. Among them were 64 patients with severe trauma (Injury Severity Score (ISS) \u2265 16), 51 patients with moderate trauma (ISS &lt; 16) and 49 patients with single fractures (24 femur neck and 25 ankle fractures). Disease severity was objectified by ISS and Glasgow Coma Scale (GCS). Results: cfDNA levels in plasma and serum were significantly higher in patients with severe multiple trauma (SMT) than in those with moderate trauma (p = 0.002, p = 0.003, respectively) or with single fractures (each p &lt; 0.001). CfDNA in plasma and serum correlated very strongly with each other (R = 0.91; p &lt; 0.001). The AUC in ROC curves for identification of SMT patients was 0.76 and 0.74 for cfDNA in plasma and serum, respectively\u2014this was further increased to 0.84 by the combination of cfDNA and hemoglobin. Within the group of multiple trauma patients, cfDNA levels were significantly higher in more severely injured patients and patients with severe traumatic brain injury (GCS \u2264 8 versus GCS &gt; 8). Thirteen (20.3%) of the multiple trauma patients died during the first week after trauma. Levels of cfDNA were significantly higher in non-surviving patients than in survivors (p &lt; 0.001), reaching an AUC of 0.81 for cfDNA in both, plasma and serum, which was further increased by the combination with hemoglobin and leukocytes. Conclusions: cfDNA is valuable for estimation of trauma severity and prognosis of trauma patients.<\/jats:p>","DOI":"10.3390\/diagnostics13061150","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T05:06:01Z","timestamp":1679029561000},"page":"1150","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Cell-Free DNA in Plasma and Serum Indicates Disease Severity and Prognosis in Blunt Trauma Patients"],"prefix":"10.3390","volume":"13","author":[{"given":"Inga","family":"Trulson","sequence":"first","affiliation":[{"name":"Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Center, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Stahl","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry, University Hospital Munich-Grosshadern, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Margraf","sequence":"additional","affiliation":[{"name":"Leukocare AG, 81379 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Scholz","sequence":"additional","affiliation":[{"name":"Leukocare AG, 81379 Munich, Germany"},{"name":"Department of Traumatology and Hand Surgery, Heinrich Heine University, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Hoecherl","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, M\u00fcnchen Klinik, 81545 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, M\u00fcnchen Klinik, 81545 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juergen","family":"Durner","sequence":"additional","affiliation":[{"name":"Laboratory Becker MVZ GbR, 81671 Munich, Germany"},{"name":"Department of Conservative Dentistry and Periodontology, University Hospital, LMU, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9613-182X","authenticated-orcid":false,"given":"Frank","family":"Klawonn","sequence":"additional","affiliation":[{"name":"Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Center, 80636 Munich, Germany"},{"name":"Department of Computer Science, Ostfalia University, 38302 Wolfenb\u00fcttel, Germany"},{"name":"Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9210-7064","authenticated-orcid":false,"given":"Stefan","family":"Holdenrieder","sequence":"additional","affiliation":[{"name":"Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Center, 80636 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,17]]},"reference":[{"key":"ref_1","unstructured":"(2022, April 27). 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