Does tumor necrosis factor alpha promoter -308 A/G polymorphism has any role in the susceptibility to sepsis and sepsis risk? A meta-analysis.

Sepsis is defined as an infection that causes the immune system to attack the body, subsequently leading to death. Some findings suggest that there is a high level of correlation between tumor necrosis factor (TNF) activity and susceptibility to sepsis. We used MEDLINE, Scopus and Web of Science databases to conduct an automated search covering the years 2000-2019. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for the meta-analysis. The selected studies were evaluated based on their focus on the TNF-α -308 A/G polymorphism, sepsis and sepsis mortality. Based on this inclusion criterion, 24 papers out of 782 were chosen for the meta-analysis. The meta-analysis was performed using Review Manager. The comparison of TNF1 and TNF2 among the patients was calculated in the 2 groups and the odds ratio (OR) was used to construct the forest plots. The meta-analysis of the OR in Asian and Caucasian populations does not prove the influence of TNF variant on sepsis risk.

Platelets as a prognostic marker for sepsis: A cohort study from the MIMIC-III database.

During sepsis, platelets dysfunction contributes to organ dysfunction. Studies on platelets dysfunction in the long-term prognosis of sepsis are lacking. The aim of this study was to assess the role of platelets in the long-term prognosis of sepsis patients.A total of 4576 sepsis patients were extracted from MIMIC III Database. Survival was analyzed by the Kaplan-Meier method. Univariate and multivariate cox analyses were performed to identify prognostic factors. Significant prognostic factors were combined to build a nomogram to predict 1 year overall survival (OS). The discriminative ability and predictive accuracy of the nomogram were evaluated using the receiver operating characteristic curve (ROC) analysis and calibration curves used for sepsis.The more abnormal the platelet level, the worse prognosis of patients. After final regression analysis, age, blood urea nitrogen, platelets, international normalized ratio, partial thromboplastin time, potassium, hemoglobin, white blood cell count, organ failures were found to be independent predictors of 1 year OS of sepsis patient and were entered into a nomogram. The nomogram showed a robust discrimination, with an area under the receiver operating characteristic curve of 0.752. The calibration curves for the probability of the prognosis of sepsis patients showed optimal agreement between the probability as predicted by the nomogram and the actual probability.Platelet was an independent prognostic predictor of 1 year OS for patients with sepsis. Platelet-related nomogram that can predict the 1 year OS of sepsis patients. It revealed optimal discrimination and calibration, indicating that the nomogram may have clinical utility.