title: Outcome prediction in sepsis combined use of genetic polymorphisms - A study in Japanese population.
abstract: Genetic polymorphisms have recently been found to be related to clinical outcome in septic patients. The present study investigated to evaluate the influence of genetic polymorphisms in Japanese septic patients on clinical outcome and whether use of genetic polymorphisms as predictors would enable more accurate prediction of outcome. Effects of 16 genetic polymorphisms related to pro-inflammatory mediators and conventional demographic/clinical parameters (age, sex, past medical history, and APACHE II score) on ICU mortality as well as disease severity during ICU stay were examined in the septic patients (n=123) admitted to the ICU between October 2001 and November 2007 by multivariable logistic regression analysis. ICU mortality was significantly associated with TNF -308GA, IL1β -31CT/TT, and APACHE II score. Receiver-operating characteristics (ROC) analysis demonstrated that, compared with APACHE II score alone (ROC-AUC=0.68), use of APACHE II score and two genetic parameters (TNF -308 and IL1β -31) enabled more accurate prediction of ICU mortality (ROC-AUC=0.80). Significant association of two genetic polymorphisms, TNF -308 and IL1β -31, with ICU mortality was observed in septic patients. In addition, combined use of these genetic parameters with APACHE II score may enable more accurate prediction of outcome in septic patients.
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University, Japan. umitanago@k9.dion.ne.jp
authors.forename: Tadanaga
authors.initials: T
authors.lastname: Shimada
authors.forename: Shigeto
authors.initials: S
authors.lastname: Oda
authors.forename: Tomohito
authors.initials: T
authors.lastname: Sadahiro
authors.forename: Masataka
authors.initials: M
authors.lastname: Nakamura
authors.forename: Yoh
authors.initials: Y
authors.lastname: Hirayama
authors.forename: Eizo
authors.initials: E
authors.lastname: Watanabe
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Abe
authors.forename: Taka-aki
authors.initials: TA
authors.lastname: Nakada
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Tateishi
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Otani
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hirasawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tokuhisa
authors.forename: Hajime
authors.initials: H
authors.lastname: Uno
mesh_terms: D018806:APACHE; D000368:Aged; D019540:Area Under Curve; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D015850:Interleukin-6 / Q000097:blood; D007564:Japan; D008297:Male; D008875:Middle Aged; D008957:Models, Genetic; D011110:Polymorphism, Genetic; D012372:ROC Curve; D018805:Sepsis / Q000097:blood* / Q000235:genetics*; D016896:Treatment Outcome
chemical_list: D015850:Interleukin-6