Sepsis-related mortality and morbidity are major health care problems worldwide. More effort is required to identify factors associated with adverse outcome. Evaluate the prognostic capacity of tumor necrosis factor (TNF), kidney injury molecule (KIM), and lactate and TNF-α-308 G > A gene polymorphism for prediction of 28 days-intensive care unit (ICU) mortality. TNF-α-308 G > A single nucleotide polymorphisms was detected by real-time-PCR on 112 had septic shock and 88 were septic. Serum TNF-α and urinary KIM were assessed by enzyme-linked immunosorbent assay. This study included 200 critically ill patients, 125 (62.5%) of them died within 28 days in ICU (nonsurvivors). Frequencies of TNF-308 G > A was (70.7) GG, (28) GA and (1.3) AA in survivors versus (85.6) GG, (12) GA and (2.4) AA for nonsurvivors, revealed significant association with ICU mortality but not sepsis severity (p = 0.15) or sepsis-induced acute kidney injury (AKI). In contrast, urinary KIM-1 revealed significant association with sepsis severity (p = 0.036) and AKI (p = 0.0001), but not 28-days ICU mortality. The relative risk of death in patients with GG genotype was 2.5 mainly in ICU younger male patients (odds ratios 24 and 4.9, p = 0.001). The genotype GG and GA were significantly associated with [increased urinary KIM-1 (0.29 ± 0.1) (p = 0.0001), terminal creatinine (1.67 ± 0.8) (p = 0.0001)] and [increased terminal urea (109 ± 0.001) (p = 0.001) and basal serum TNF (60 ± 0.001) (p = 0.0001)], respectively. In linear regression analysis, AKI 0.0001 (0.4–0.67), basal serum TNF 0.04 (0.0001–0.04), and TNF-308 GG 0.007 (0.05–0.33) were associated with 28 days ICU mortality [p value (95% confidence interval)]. The same results were observed for initial urea 0.024 (0.0001–0.003) and lack of diuretic usage 0.0001 (0.35–0.7) mainly in septic patients. Major frequency of TNF-308 G > A polymorphism (mainly in young age male patients), AKI and serum TNF were associated with increased risk for 28 days-ICU mortality. Furthermore, sepsis severity was influenced by TNF and urinary KIM-1, which reflects in AKI.

中文翻译：

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严重疾病患者的TNF-α-308（G> A）（rs1800629）基因多态性与败血症的不良结局相关。

败血症相关的死亡率和发病率是全世界主要的卫生保健问题。需要更多的努力来确定与不良后果相关的因素。评估肿瘤坏死因子（TNF），肾损伤分子（KIM）以及乳酸和TNF-α-308G>基因多态性对28天重症监护病房（ICU）死亡率的预测的预后能力。TNF-α-308G>实时荧光定量PCR检测112例败血性休克和88例败血性单核苷酸多态性。血清TNF-α和尿KIM通过酶联免疫吸附测定进行评估。该研究包括200名重症患者，其中125名（62.5％）在重症监护病房（非幸存者）中于28天内死亡。TNF-308 G> A的频率存活者的（70.7）GG，（28）GA和（1.3）AA与非存活者的（85.6）GG，（12）GA和（2.4）AA显着相关，与ICU死亡率相关，但与败血症的严重程度无关（p  = 0.15）或败血症引起的急性肾损伤（AKI）。相比之下，尿KIM-1与脓毒症严重程度（p  = 0.036）和AKI（p  = 0.0001）显着相关，但与28天ICU死亡率无关。GG基因型患者的相对死亡风险主要在ICU年轻男性患者中为2.5（比值分别为24和4.9，p  = 0.001）。GG和GA基因型与[尿KIM-1增加（0.29±0.1）（p  = 0.0001），终末肌酐（1.67±0.8）（p = 0.0001）和[末端尿素增加（109±0.001）（p  = 0.001）和基础血清TNF（60±0.001）（p  = 0.0001）]。在线性回归分析中，AKI 0.0001（0.4–0.67），基础血清TNF 0.04（0.0001-0.04）和TNF-308 GG 0.007（0.05–0.33）与28天ICU死亡率相关[ p值（95％置信区间） ]。初始尿素为0.024（0.0001-0.003），而利尿剂的使用率为0.0001（0.35-0.7），主要在败血症患者中观察到相同的结果。TNF-308 G的主要频率> A多态性（主要在年轻男性患者中），AKI和血清TNF与28天ICU死亡风险增加相关。此外，败血症的严重程度受TNF和尿KIM-1的影响，这反映在AKI中。