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Simple blood test could save doctors hours of diagnosis

Ground-breaking new research is underway at Barts and The London School of Medicine and Dentistry which means doctors are close to identifying clinically useful biomarkers – compounds found in the blood - that will revolutionise trauma care and allow surgeons to diagnose which organs are injured, and to what extent, as soon as they arrive at hospital.

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This means patients with gunshot or knife wounds or with multiple injuries from road traffic accidents or from big falls may be able to have a new style diagnosis of their injuries in minutes. At present it can take trauma doctors hours or even days to diagnose a trauma patient’s injuries fully.

The new blood test would also enable doctors to give appropriate treatment to patients earlier and predict outcomes for patients very early in their clinical course, allowing targeted rehabilitation programmes to be implemented.

The research, in its early stages, is part of a three year programme. If sufficient biomarkers and proteins are identified, the new blood test would be available to trauma patients at The Royal London Hospital in Whitechapel.

Trauma is one of the leading causes of death and disability.  Worldwide it is responsible for over six million deaths per year, and it is the only disease in the United Kingdom with an increasing mortality rate.

Karim Brohi, Consultant Trauma & Vascular Surgeon at the Barts and The London NHS Trust and Professor of Trauma Sciences at Barts and The London School of Medicine and Dentistry is leading the research. He said:

“Currently the care of injured patients is somewhat restricted by the lack of trauma biomarkers; these allow us to measure both total injury to the body and specific injuries such as brain and spinal cord injury, accurately and rapidly.

“A biomarker is a compound that is easily measured in the blood in a concentration that is related to the number of cells that have been damaged. The challenge is to find the right biomarkers that can inform us about a trauma patient’s injuries. The human body has over 25,000 proteins, a few of which will be candidates for trauma biomarkers.

“For example, it may be days or weeks before the full extent of brain or spinal cord injury is known.  Understanding and predicting how an individual’s body may respond to serious trauma is really the key to ensuring a patient survives, and that their long-term outcomes are positive and they have a reasonable quality of life.

“This is the first research in the UK that is looking at trauma biomarkers in severely injured patients; researchers in the US are also attempting to identify biomarkers of risk for post-traumatic stress disorder in military personnel who have recently returned from war zones;

So far 200 major trauma patients admitted to The Royal London have had a blood sample taken as part of a study on the early responses of the body to injury. A small amount of this sample is being used for the biomarker study.  A total of 500 patients will be enrolled for this study.

Once a sample has been taken, levels of biomarkers in patients will be compared with diagnostic imaging of injuries and other measures of injury severity; these will be correlated with the clinical outcomes of patients. Blood samples will also be analysed to search for new proteins that may be suitable as biomarkers.

Specialised medical equipment is used to identify biomarkers in the blood.

The research will be partly funded by a £20,000 donation made recently to Barts and The London NHS Trust by Irwin Mitchell, clinical negligence and personal injury lawyers.

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