Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Crit Care Med. 2000 Aug;28(8):2733-6.

Tumor necrosis factor gene polymorphism and septic shock in surgical infection.

Author information

  • 1Department of Anesthesiology and Surgical Critical Care, Veterans General Hospital-Taipei, Taiwan, Republic of China.

Abstract

OBJECTIVES:

To evaluate the relationship of the genotype distribution of the tumor necrosis factor (TNF)-alpha polymorphism with regard to the plasma TNF-alpha concentration and the development of septic shock as well as mortality of infected patients in a surgical intensive care unit (SICU).

DESIGN:

A total of 112 postoperative critically ill infected patients were prospectively enrolled.

SETTING:

SICU of a tertiary university-affiliated medical center.

PATIENTS:

Patients who were consecutively admitted to the SICU because of surgical infection with sepsis.

INTERVENTION:

Blood sampling.

MEASUREMENTS AND MAIN RESULTS:

Blood sample was obtained 24 hrs after intensive care unit (ICU) admission or within 2 hrs after the onset of septic shock to determine the plasma TNF-alpha level and to analyze the genotype of the biallelic polymorphism of the TNF-alpha.

RESULTS:

The allele frequency of the TNF2 in our infected ICU patients was 12%. Forty-two (37.5%) patients admitted fulfilled the criteria of septic shock during their ICU stay. Patients carrying the TNF2 allele were not more likely to develop septic shock, nor did they have a higher mortality rate. In the patients with septic shock, those carrying the TNF2 allele had a significantly higher mortality rate than those with the homozygous TNF1 genotype (92% vs. 62%, p < .05). In those who developed septic shock, the TNF2 allele was significantly associated with higher TNF levels.

CONCLUSION:

In patients admitted to SICU with surgical infection, the frequency of TNF2 allele was higher than in the general population. SICU patients with TNF2 allele did not show a higher incidence of developing septic shock, nor was there a higher baseline TNF-alpha level after infection. However, once septic shock had developed, the mortality rate was higher in those patients carrying the TNF2 allele.

Comment in

PMID:
10966243
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins
    Loading ...
    Write to the Help Desk