title: The G-->A single nucleotide polymorphism at the -308 position in the tumor necrosis factor-alpha promoter increases the risk for severe sepsis after trauma.
abstract: BACKGROUND
  Clinical factors do not adequately explain why some patients develop severe sepsis after trauma and why others do not. We sought to determine whether genetic factors contribute to this risk.
  
  
  METHODS
  Patients admitted to a single Level I trauma center were enrolled and DNA was isolated from leukocytes. The risk for severe sepsis and for death associated with polymorphism in the tumor necrosis factor-alpha promoter was determined by multivariate analysis.
  
  
  RESULTS
  One hundred fifty-two patients had a 24% incidence of severe sepsis and a 13% case fatality rate. The A-allele was most common at the -308 position (n = 35). A-allele carriage at this location was associated with an adjusted odds ratio of 4.6 (95% confidence interval, 1.9-10.9) for severe sepsis and of 2.1 (95% confidence interval, 0.6-7.3) for death.
  
  
  CONCLUSIONS
  The A-allele at the -308 position in the tumor necrosis factor-alpha promoter increases the risk for severe sepsis and possibly for death after trauma.
authors: Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas 75390-9158, USA. grant.o'keefe@utsouthwestern.edu
authors: Grant E
authors: GE
authors: O'Keefe
authors: Dixie L
authors: DL
authors: Hybki
authors: Robert S
authors: RS
authors: Munford
mesh_terms: D000328:Adult; D005260:Female; D005787:Gene Frequency / Q000235:genetics; D005838:Genotype; D006801:Humans; D008297:Male; D016017:Odds Ratio; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D011401:Promoter Regions, Genetic / Q000235:genetics*; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology* / Q000235:genetics* / Q000401:mortality; D015599:Trauma Severity Indices; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics*; D014947:Wounds and Injuries / Q000150:complications* / Q000401:mortality
chemical_list: D014409:Tumor Necrosis Factor-alpha