Distinct immunologic endotypes are associated with clinical trajectory after severe blunt trauma and hemorrhagic shock
Autor: | Frederick A. Moore, Babette Brumback, Russell B. Hawkins, Alicia M. Mohr, Ronald V. Maier, Zhongkai Wang, Scott C. Brakenridge, Steven L. Raymond, Philip A. Efron, Gabriela L. Ghita, Dijoia B Darden, Michael J. Cox, Joseph Cuschieri, Lyle L. Moldawer |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Endotype Endophenotypes medicine.medical_treatment Shock Hemorrhagic Wounds Nonpenetrating Critical Care and Intensive Care Medicine Gastroenterology Article Cohort Studies 03 medical and health sciences 0302 clinical medicine Trauma Centers Internal medicine medicine Humans Longitudinal Studies Prospective Studies Prospective cohort study Immunosuppression Therapy Cross Infection business.industry Incidence (epidemiology) Organ dysfunction 030208 emergency & critical care medicine Immunosuppression Length of Stay Systemic Inflammatory Response Syndrome Treatment Outcome Blunt trauma Cohort Surgery medicine.symptom Cytokine Release Syndrome business Biomarkers Follow-Up Studies Cohort study |
Zdroj: | J Trauma Acute Care Surg |
ISSN: | 2163-0763 2163-0755 |
Popis: | BACKGROUND The genomic/cytokine "storm" after severe trauma is well described. However, the differing composition, magnitude and resolution of this response, and its relationship to clinical outcomes remain unclear. METHODS This is a secondary analysis of a prospective longitudinal cohort study of severely injured trauma patients in hemorrhagic shock. Peripheral blood sampling was performed at 0.5, 1, 4, 7, 14, and 28 days after injury for measurement of circulating immune biomarkers. K-means clustering using overall mean and trajectory slope of selected immunologic biomarkers were used to identify distinct temporal immunologic endotypes. Endotypes were compared with known clinical trajectories defined as early death ( |
Databáze: | OpenAIRE |
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