Department of Anaesthesiology, University Medical Centre, Georg August University, Robert-Koch-Str.40, D-37075, Goettingen, Germany.
Department of Cardiothoracic Transplantation & Mechanical Support, Royal Brompton and Harefield Hospital, Harefield, Hill End Road, UB9 6JH, London, United Kingdom.
Sci Rep. 2017 Aug 29;7(1):9887. doi: 10.1038/s41598-017-08540-7.
A recent genome-wide association study showed that a genetic variant within the FER gene is associated with survival in patients with sepsis due to pneumonia. Because severe pneumonia is the main cause of acute respiratory distress syndrome (ARDS), we aimed to investigate the effect of the FER polymorphism rs4957796 on the 90-day survival in patients with ARDS due to pneumonia. An assessment of a prospectively collected cohort of 441 patients with ARDS admitted to three intensive care units at the University Medical Centre identified 274 patients with ARDS due to pneumonia. The 90-day mortality risk was recorded as the primary outcome parameter. Sepsis-related organ failure assessment (SOFA) scores and organ support-free days were used as the secondary variables. FER rs4957796 TT-homozygous patients were compared with C-allele carriers. The survival analysis revealed a higher 90-day mortality risk among T homozygotes than among C-allele carriers (p = 0.0144) exclusively in patients with severe ARDS due to pneumonia. The FER rs4957796 TT genotype remained a significant covariate for the 90-day mortality risk in the multivariate analysis (hazard ratio, 4.62; 95% CI, 1.58-13.50; p = 0.0050). In conclusion, FER rs4957796 might act as a prognostic variable for survival in patients with severe ARDS due to pneumonia.
一项最近的全基因组关联研究表明,FER 基因内的一个遗传变异与肺炎引起的脓毒症患者的生存有关。由于严重肺炎是急性呼吸窘迫综合征(ARDS)的主要原因,我们旨在研究 FER 多态性 rs4957796 对肺炎引起的 ARDS 患者 90 天生存率的影响。评估了在大学医疗中心的三个重症监护病房住院的 441 名 ARDS 患者的前瞻性收集队列,确定了 274 名肺炎引起的 ARDS 患者。90 天死亡率风险被记录为主要结局参数。脓毒症相关器官衰竭评估(SOFA)评分和无器官支持天数用作次要变量。FER rs4957796 TT 纯合子患者与 C 等位基因携带者进行比较。生存分析显示,与 C 等位基因携带者相比,T 纯合子的 90 天死亡率风险更高(p=0.0144),仅在严重肺炎引起的 ARDS 患者中如此。在多变量分析中,FER rs4957796 TT 基因型仍然是 90 天死亡率风险的显著协变量(危险比,4.62;95%置信区间,1.58-13.50;p=0.0050)。总之,FER rs4957796 可能是严重肺炎引起的 ARDS 患者生存的预后变量。