title: Mitochondrial DNA haplogroups are associated with severe sepsis and mortality in patients who underwent major surgery.
abstract: OBJECTIVE
  To analyse whether mitochondrial DNA (mtDNA) haplogroups are associated with severe sepsis and mortality after major surgery.
  
  
  METHODS
  We performed a case-control study on 240 cardiac or abdominal surgery patients developing severe sepsis (Case-group) and 267 cardiac or abdominal surgery patients without severe sepsis and with systemic inflammatory response syndrome (SIRS, Control-group). Furthermore, a longitudinal substudy was performed for analysing the survival in septic patients. Only European white patients within the N macro-cluster were included.
  
  
  RESULTS
  Case-group underwent cardiac surgery had lower frequencies of cluster HV (p = 0.005) and haplogroup H (p = 0.005) and higher frequencies of cluster JT (p = 0.028) than Control-group; but no significant differences were found for abdominal surgery. Besides, both cluster HV and haplogroup H were associated with decreased odds of severe sepsis (adjusted odds ratio (aOR) = 0.45 (95%CI = 0.25; 0.82); p = 0.009 and aOR = 0.48 (95%CI = 0.26; 0.87); p = 0.015, respectively) among patients underwent cardiac surgery. In Case-group, 45.4% (109/240) patients died with a survival median of 39 (95%CI = 31.4; 46.62) days. When the clusters were examined, 41% (55/134) patients within cluster HV died versus 71.4% (10/14) patients within cluster IWX (p = 0.018). Additionally, patients within cluster IWX had an increased risk of death (adjusted hazard ratio (aHR) = 2.22; (95%CI = 1.14; 4.34); p = 0.019).
  
  
  CONCLUSIONS
  European mitochondrial haplogroups might be related to the onset of severe sepsis in patients who underwent major cardiac surgery, but not in patients underwent major abdominal surgery. Besides, mtDNA haplogroups could have influence on mortality in septic patients.
authors.affiliation: Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain. Electronic address: majimenezsousa@yahoo.es.
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Jiménez-Sousa
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Clínico Universitario, Valladolid, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tamayo
authors.affiliation: Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Guzmán-Fulgencio
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Clínico Universitario, Valladolid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Heredia
authors.affiliation: Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.
authors.forename: Amanda
authors.initials: A
authors.lastname: Fernández-Rodríguez
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Clínico Universitario, Valladolid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Gómez
authors.affiliation: Unidad de Investigación Médica en Infección e Inmunidad, Hospital Clínico Universitario-IECSCYL, Valladolid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Almansa
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Clínico Universitario, Valladolid, Spain.
authors.forename: José I
authors.initials: JI
authors.lastname: Gómez-Herreras
authors.affiliation: Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: García-Álvarez
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Clínico Universitario, Valladolid, Spain.
authors.forename: Sandra
authors.initials: S
authors.lastname: Gutiérrez-Junco
authors.affiliation: Unidad de Investigación Médica en Infección e Inmunidad, Hospital Clínico Universitario-IECSCYL, Valladolid, Spain.
authors.forename: Jesús F
authors.initials: JF
authors.lastname: Bermejo-Martin
authors.affiliation: Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain. Electronic address: sresino@isciii.es.
authors.forename: Salvador
authors.initials: S
authors.lastname: Resino
mesh_terms: D018806:APACHE; D000005:Abdomen / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects; D016022:Case-Control Studies; D004272:DNA, Mitochondrial / Q000235:genetics*; D005260:Female; D013502:General Surgery; D005838:Genotype; D006239:Haplotypes / Q000235:genetics; D006801:Humans; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D018805:Sepsis / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality*; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis; D044465:White People
chemical_list: D004272:DNA, Mitochondrial
keywords: Genetic polymorphism; Mitochondrial haplogroups; Severe sepsis; Survival; Systemic inflammatory response syndrome (SIRS); mtDNA