دورية أكاديمية
Long-term Host Immune Response Trajectories Among Hospitalized Patients With Sepsis.
| العنوان: | Long-term Host Immune Response Trajectories Among Hospitalized Patients With Sepsis. |
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| المؤلفون: | Yende, Sachin, Kellum, John A, Talisa, Victor B, Peck Palmer, Octavia M, Chang, Chung-Chou H, Filbin, Michael R, Shapiro, Nathan I, Hou, Peter C, Venkat, Arvind, LoVecchio, Frank, Hawkins, Katrina, Crouser, Elliott D, Newman, Anne B, Angus, Derek C |
| المصدر: | Anesthesiology and Critical Care Medicine Faculty Publications |
| بيانات النشر: | Health Sciences Research Commons |
| سنة النشر: | 2019 |
| المجموعة: | George Washington University: Health Sciences Research Commons (HSRC) |
| مصطلحات موضوعية: | Aged, B7-H1 Antigen, Biomarkers, C-Reactive Protein, Comorbidity, Female, Humans, Immunocompetence, Inflammation, Male, Middle Aged, Organ Dysfunction Scores, Patient Readmission, Prospective Studies, Sepsis, Anesthesia and Analgesia, Anesthesiology, Critical Care |
| الوصف: | Importance: Long-term immune sequelae after sepsis are poorly understood. Objective: To assess whether abnormalities in the host immune response during hospitalization for sepsis persist after discharge. Design, Settings, and Participants: This prospective, multicenter cohort study enrolled and followed up for 1 year adults who survived a hospitalization for sepsis from January 10, 2012, to May 25, 2017, at 12 US hospitals. Exposures: Circulating levels of inflammation (interleukin 6 and high-sensitivity C-reactive protein [hs-CRP]), immunosuppression (soluble programmed death ligand 1 [sPD-L1]), hemostasis (plasminogen activator inhibitor 1 and D-dimer), endothelial dysfunction (E-selectin, intercellular adhesion molecule 1, and vascular cell adhesion molecule 1), and oxidative stress biomarkers were measured at 5 time points during and after hospitalization for sepsis for 1 year. Individual biomarker trajectories and patterns of trajectories across biomarkers (phenotypes) were identified. Main Outcomes and Measures: Outcomes were adjudicated centrally and included all-cause and cause-specific readmissions and mortality. Results: A total of 483 patients (mean [SD] age, 60.5 [15.2] years; 265 [54.9%] male) who survived hospitalization for sepsis were included in the study. A total of 376 patients (77.8%) had at least 1 chronic disease, and their mean (SD) Sequential Organ Failure Assessment score was 4.2 (3.0). Readmissions were common (485 readmissions in 205 patients [42.5%]), and 43 patients (8.9%) died by 3 months, 56 patients (11.6%) died by 6 months, and 85 patients (17.6%) died by 12 months. Elevated hs-CRP levels were observed in 23 patients (25.8%) at 3 months, 26 patients (30.2%) at 6 months, and 23 patients (25.6%) at 12 months, and elevated sPD-L1 levels were observed in 45 patients (46.4%) at 3 months, 40 patients (44.9%) at 6 months, and 44 patients (49.4%) at 12 months. Two common phenotypes were identified based on hs-CRP and sPDL1 trajectories: high hs-CRP and sPDL1 levels (hyperinflammation and ... |
| نوع الوثيقة: | text |
| اللغة: | unknown |
| العلاقة: | https://hsrc.himmelfarb.gwu.edu/smhs_anesth_facpubs/461Test; http://dx.doi.org/10.1001/jamanetworkopen.2019.8686Test |
| DOI: | 10.1001/jamanetworkopen.2019.8686 |
| الإتاحة: | https://doi.org/10.1001/jamanetworkopen.2019.8686Test https://hsrc.himmelfarb.gwu.edu/smhs_anesth_facpubs/461Test |
| رقم الانضمام: | edsbas.486C1C28 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1001/jamanetworkopen.2019.8686 |
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