title: The effect of four hemostatic gene polymorphisms on the outcome of septic critically ill patients.
abstract: Genetic variants of hemostatic factors leading to prothrombotic phenotypes of hypercoagulability and hypofibrinolysis might affect prognosis of septic critically ill patients. Our aim was to evaluate the effect of four hemostatic genetic variants, namely fibrinogen-beta-455G/A, factor XIII (FXIII) V34L, plasminogen activator inhibitor-1 (PAI-1) 4G/5G polymorphisms and factor V Leiden (FVL) mutation on survival of critically ill patients with severe sepsis or septic shock. A prospective, observational study in an 18-bed general ICU included 73 patients with severe sepsis or septic shock. Epidemiological, laboratory data and comorbidities along with severity scores were recorded. Genotyping for fibrinogen-beta-455G/A, FXIII V34L and PAI-1 4G/5G polymorphism and FVL mutation was carried out in all patients. The primary outcomes were the 28-day and the 90-day survival. Age, septic shock, severity indexes, prior steroid use and arterial pH were identified as predictors of the 28-day and 90-day survival in both the univariate and the multivariate models. On the contrary, none of the examined polymorphisms was found to significantly affect either the 28-day or the 90-day survival. Our data suggest that the importance of these hemostatic polymorphisms as predictors of the prognosis of sepsis in critically ill patients is probably very small.
authors.affiliation: Laboratory of Haematology & Blood Bank Unit, Attikon University General Hospital, Medical School, University of Athens, 1 Rimini Str., Athens, Greece. atsantes@yahoo.com
authors.forename: Argirios E
authors.initials: AE
authors.lastname: Tsantes
authors.forename: Iraklis
authors.initials: I
authors.lastname: Tsangaris
authors.forename: Stefanos
authors.initials: S
authors.lastname: Bonovas
authors.forename: Petros
authors.initials: P
authors.lastname: Kopterides
authors.forename: Evdoxia
authors.initials: E
authors.lastname: Rapti
authors.forename: Ioanna
authors.initials: I
authors.lastname: Dimopoulou
authors.forename: Christos
authors.initials: C
authors.lastname: Markatos
authors.forename: Stylianos
authors.initials: S
authors.lastname: Orfanos
authors.forename: Apostolos
authors.initials: A
authors.lastname: Armaganidis
authors.forename: Anthi
authors.initials: A
authors.lastname: Travlou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000401:mortality*; D005165:Factor V / Q000235:genetics*; D005176:Factor XIII / Q000235:genetics*; D005260:Female; D005340:Fibrinogen / Q000235:genetics*; D005838:Genotype; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D017395:Plasminogen Activator Inhibitor 1 / Q000235:genetics*; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D018805:Sepsis / Q000401:mortality*; D012772:Shock, Septic / Q000401:mortality; D055815:Young Adult
chemical_list: D017395:Plasminogen Activator Inhibitor 1; C095381:factor V Leiden; D005165:Factor V; D005340:Fibrinogen; D005176:Factor XIII