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OLFM4 polymorphisms predict septic shock survival after major surgery
Author(s) -
PérezGarcía Felipe,
Resino Salvador,
GómezSánchez Esther,
GonzaloBenito Hugo,
FernándezRodríguez Amanda,
LorenzoLópez Mario,
HerediaRodríguez María,
GómezPesquera Estefanía,
Tamayo Eduardo,
JiménezSousa Maria Ángeles
Publication year - 2021
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13416
Subject(s) - septic shock , medicine , single nucleotide polymorphism , proportional hazards model , hazard ratio , receiver operating characteristic , oncology , gastroenterology , genotype , surgery , sepsis , confidence interval , genetics , biology , gene
Background Higher expression of olfactomedin‐4 (OLFM4), a gene regulated by nuclear factor‐kappa B (NF‐κB), has been related to a higher risk of organ failure and death in patients with septic shock. We aimed to evaluate the association between OLFM4 single nucleotide polymorphisms (SNPs) and septic shock‐related death in 175 patients who underwent major surgery, as well as its performance in predicting mortality. Materials and methods We carried out a retrospective study. A total of seven OLFM4 SNPs were genotyped by Agena Bioscience's MassARRAY platform. Statistical analysis was performed by Kaplan‐Meier and Cox regression tests. The diagnostic performance for predicting septic shock‐related death was evaluated by the area under the receiver‐operating characteristic (AUROC) curve. Results Patients with rs17552047 A allele and rs1891944 TT genotype had higher survival than patients with rs17552047 G allele ( P ‐value = .024) and patients with rs1891944 CC/CT genotype ( P ‐value = .038). However, only rs17552047 was associated with a lower risk of death under an additive inheritance model (adjusted hazard ratio [aHR] = 0.44, 95% CI = 0.27‐0.71). The multivariate model with the most significant clinical variables (lactate, chronic kidney disease, peritonitis, heart disease and elective surgery) showed an AUROC of 0.776 for predicting septic shock‐related death. When we added the OLFM4 rs17552047 SNP to the previous model, the AUROC was 0.811 and was close to reaching significant differences with the previous model ( P ‐value = .065). Conclusion OLFM4 rs17552047 A allele predicts septic shock survival in patients who underwent major surgery. Furthermore, rs17552047, together with clinical variables, could be useful to predict the outcome of septic shock.