Predictive Value of Serum HMGB1 Change Trajectory Before and After Decompressive Craniectomy in Patients with Craniocerebral Trauma for Neurological Outcome
WANG Fuxi
WANG Xiangxiang
QIN Ruihong
Abstract：Objective To investigate the predictive value of the change trajectory of serum high mobility group protein B1(HMGB1)levels before and after decompressive craniectomy in patients with craniocerebral trauma for neurological outcomes.Methods A total of 181 patients with craniocerebral trauma were prospectively selected from January 2022 to October 2024 in the Seventh People's Hospital of Zhengzhou,decompressive craniectomy was performed in all patients.The change trajectories of serum HMGB1 levels before surgery,and one and two weeks after surgery,were statistically analyzed.Latent class trajectory model(LCTM)was used to establish the change trajectories of serum HMGB1 levels and to categorize patients.The general characteristics and adverse neurological outcomes of the three trajectory groups were compared.Logistic regression analysis was employed to investigate the impact of HMGB1 change trajectory on adverse neurological outcomes.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of HMGB1 change trajectory for adverse neurological outcomes.Results The preoperative,postoperative 1-week,and postoperative 2-week serum HMGB1 levels in 181 patients with craniocerebral injury were(9.20±1.34),(7.42±1.20),and(4.66±0.85)μg·L-1,respectively,showing a decreasing trend(P＜0.05).The LCTM fitting indicated that the optimal model was with three classification trajectories,specifically subgroup 1(rapid decline group,57 cases),subgroup 2(gradual decline group,80 cases),and subgroup 3(slow decline group,44 cases).The preoperative,postoperative 1-week,and postoperative 2-week serum HMGB1 levels in the slow decline group were higher than those in the gradual decline group and the rapid decline group,with the gradual decline group being higher than the rapid decline group(P＜0.05).The slow decline group had higher intracranial hematoma volume,Glasgow coma scale(GCS)scores,diabetes,and incidence of poor neurological outcomes at 3 months post-surgery than those the gradual decline and rapid decline groups(P＜0.05).After adjusting for confounding factors such as intracranial hematoma,GCS scores,and diabetes,the slow decline trajectory of serum HMGB1 levels was an influencing factor for poor neurological outcomes in patients with craniocerebral trauma(OR=1.551,95％CI:1.211-1.986,P＜0.05).The area under the curve for predicting poor neurological outcomes in patients with a slow decline trajectory of serum HMGB1 levels was 0.723,with a sensitivity of 63.64％and a specificity of 81.02％.Conclusion The establishment of the change trajectory of the serum HMGB1 can effectively predict the neurological outcome of patients with craniocerebral trauma after decompressive craniectomy,guide clinical treatment decisions,and delay disease progression.
Keywords：craniocerebral traumadecompressive craniectomyhigh mobility group protein B1trajectory of changeneurological outcome
Publication Date：2026-06-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 1991-1995 )