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Abstract
Coagulation alterations manifest early after severe burns and are closely linked to mortality outcomes. Nevertheless, the precise characterization of coagulation changes associated with early mortality remains elusive. We examined alterations in indicators linked to mortality outcomes at both the transcriptomic and clinical characteristic levels. At the transcriptomic level, we pinpointed 28 differentially expressed coagulation-related genes (DECRGs) following burn injuries and endeavored to validate their causal relationships through Mendelian randomization. DECRGs tied to survival exhibit a significant association with neutrophil function, wherein the expression of CYP4F2 and P2RX1 serves as robust predictors of fatal outcomes. In terms of clinical indicators, early levels of D-dimer and alterations in serum calcium show a strong correlation with mortality outcomes. Coagulation depletion and fibrinolytic activation, stemming from the hyperactivation of coagulation pathways post-severe burns, are strongly linked to patient mortality. Monitoring these early coagulation markers with predictive value can effectively identify individuals necessitating priority critical care.
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Details
1 Nanchang University, Medical Center of Burn Plastic and Wound Repair, The First Affiliated Hospital, Jiangxi Medical College, Nanchang, China (GRID:grid.260463.5) (ISNI:0000 0001 2182 8825)
2 School of Medicine, Tongji University, Department of Critical Care Medicine, Shanghai East Hospital, Shanghai, China (GRID:grid.24516.34) (ISNI:0000000123704535)
3 Zhangjiagang First People’s Hospital, Department of Burns and Plastic Surgery, Suzhou, China (GRID:grid.460159.f)
4 Jinan University, Department of Burns, Guangzhou Red Cross Hospital, Guangzhou, China (GRID:grid.258164.c) (ISNI:0000 0004 1790 3548)
5 the First Affiliated Hospital of Naval Medical University, ICU of Burn and Trauma, Shanghai, China (GRID:grid.412636.4)
6 Affiliated Hospital of Nantong University, Department of Burns and Plastic Surgery, Nantong, China (GRID:grid.440642.0) (ISNI:0000 0004 0644 5481)
7 The 924th Hospital of the Chinese People’s Liberation Army, Department of Burns and Plastic Surgery, Guilin, China (GRID:grid.440642.0)
8 Zhengzhou First People’s Hospital, Department of Burns and Plastic Surgery, Zhengzhou, China (GRID:grid.440642.0)
9 the Fourth People’s Hospital of Dalian, Department of Burns and Plastic Surgery, Dalian, China (GRID:grid.410604.7)
10 Fujian Medical University Union Hospital, Department of Burns, Fuzhou, China (GRID:grid.411176.4) (ISNI:0000 0004 1758 0478)
11 Heilongjiang Provincial Hospital, Department of Burn Surgery, Harbin, China (GRID:grid.413985.2) (ISNI:0000 0004 1757 7172)
12 Taizhou Hospital of Zhejiang Province, Department of Burns, Linhai, China (GRID:grid.469636.8)
13 Wuhan Third Hospital, Department of Burns, Wuhan, China (GRID:grid.460060.4)
14 School of Medicine, Tongji University, Department of Critical Care Medicine, Shanghai East Hospital, Shanghai, China (GRID:grid.24516.34) (ISNI:0000000123704535); the First Affiliated Hospital of Naval Medical University, ICU of Burn and Trauma, Shanghai, China (GRID:grid.412636.4)