Critical Care Medicine
Feasibility of developing HAP risk warning model in critically ill patients based on genomic copy number polymorphisms of DEFA1/DEFA3
Jialian Zhao, Ya Wang, Hui Li, Caochong Yan, Shuijing Wu, Feifei Wang, Wei Wang, Haihong Wang, Xiangming Fang, Baoli Cheng
Published 2018-04-20
Cite as Chin J Anesthesiol, 2018, 38(4): 489-492. DOI: 10.3760/cma.j.issn.0254-1416.2018.04.028
Abstract
ObjectiveTo evaluate the feasibility of developing hospital acquired pneumonia(HAP)risk warning model in critically ill patients based on genomic copy number polymorphisms(CNPs)of the genes encoding human neutrophil peptides 1-3(DEFA1/DEFA3).
MethodsSeventy-seven HAP patients(group HAP)and 109 non-HAP patients of matched age and sex in intensive care unit(ICU)(group NHAP)were enrolled in the study.The genomic CNPs of DEFA1/DEFA3 was determined by real-time quantitative polymerase chain reaction after extracting DNA from peripheral blood samples.The source of patients, condition of endotracheal intubation within 24 h after admission to ICU, Acute Physiology Score, Acute Physiology and Chronic Health Evaluation Ⅱ score, Sequential Organ Failure Assessment score, mechanical ventilation time, length of hospital and ICU stay and outcomes were obtained.The predictive model was developed using logistic regression through combining DEFA1/DEFA3 copy numbers and clinical characteristics(Acute Physiology Score and source of emergency)within 24 h after admission to ICU. The receiver operating characteristic curve was used to evaluate the predictive efficacy of the model.
ResultsThe copy numbers of DEFA1/DEFA3 were significantly lower in HAP group than in NHAP group(P <0.05). The area under the receiver operating characteristic curve of the predictive model developed through combining the DEFA1/DEFA3 copy numbers with clinical characteristics was 0.789(95% CI 0.724-0.854)when the model was used for predicting HAP.
ConclusionCNPs of DEFA1/DEFA3 can be used to develop the HAP risk warning model in critically ill patients.
Key words:
alpha-Defensins; Crossinfection; Pneumonia; Hospitalization; Critical illness; DNA copy number variations
Contributor Information
Jialian Zhao
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
Ya Wang
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
Hui Li
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
Caochong Yan
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
Shuijing Wu
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
Feifei Wang
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
Wei Wang
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
Haihong Wang
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
Xiangming Fang
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
Baoli Cheng
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
