Identification of neutrophil phenotype categories in geriatric hip fracture patients aids in personalized medicine.

Autor:	Nijdam TMP; St. Antonius Ziekenhuis Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands., Jukema BN; Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.; Center for Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands., de Fraiture EJ; St. Antonius Ziekenhuis Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands.; University Medical Center Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands., Spijkerman R; St. Antonius Ziekenhuis Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands., Schuijt HJ; St. Antonius Ziekenhuis Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands., Spoelder M; Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands., Bongers CCWG; Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands., Hopman MTE; Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands., Koenderman L; Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.; Center for Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands., Hietbrink F; University Medical Center Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands., van der Velde D; St. Antonius Ziekenhuis Utrecht, Department of Trauma Surgery, Utrecht, the Netherlands.
Jazyk:	angličtina
Zdroj:	OTA international : the open access journal of orthopaedic trauma [OTA Int] 2023 Dec 22; Vol. 6 (5 Suppl), pp. e291. Date of Electronic Publication: 2023 Dec 22 (Print Publication: 2023).
DOI:	10.1097/OI9.0000000000000291
Abstrakt:	Objectives: The number of geriatric hip fracture patients is high and expected to rise in the coming years, and many are frail and at risk for adverse outcomes. Early identification of high-risk patients is crucial to balance treatment and optimize outcome, but remains challenging. Previous research in patients with multitrauma suggested that neutrophil phenotype analysis could aid in early identification of high-risk patients. This pilot study investigated the feasibility and clinical value of neutrophil phenotype analysis in geriatric patients with a hip fracture. Methods: A prospective study was conducted in a regional teaching hospital in the Netherlands. At the emergency department, blood samples were collected from geriatric patients with a hip fracture and analyzed using automated flow cytometry. Flow cytometry data were processed using an automated clustering algorithm. Neutrophil activation data were compared with a healthy control cohort. Neutrophil phenotype categories were assessed based on two-dimensional visual assessment of CD16/CD62L expression. Results: Blood samples from 45 geriatric patients with a hip fracture were included. Neutrophils showed an increased activation profile and decreased responsiveness to formyl peptides when compared to healthy controls. The neutrophil phenotype of all patients was categorized. The incidence of severe adverse outcome was significantly different between the different categories ( P = 0.0331). Moreover, patients with neutrophil phenotype category 0 developed no severe adverse outcomes. Conclusions: Using point-of-care fully automated flow cytometry to analyze the neutrophil compartment in geriatric hip fracture patients is feasible and holds clinical value in determining patients at risk for adverse outcome. This study is a first step toward immuno-based precision medicine for identifying geriatric hip fracture patients that are deemed fit for surgery. Competing Interests: All authors declare no support from any organization for the submitted work; no financial relationships with any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu