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Distinguishing septic shock from non-septic shock in postsurgical patients using gene expression

  • Pedro Martínez-Paz
    Affiliations
    Department of Surgery, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain

    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain
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  • Marta Aragón-Camino
    Affiliations
    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Anesthesiology and Resuscitation Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain
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  • Esther Gómez-Sánchez
    Affiliations
    Department of Surgery, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain

    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Anesthesiology and Resuscitation Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain
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  • Mario Lorenzo-López
    Affiliations
    Department of Surgery, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain

    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Anesthesiology and Resuscitation Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain
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  • Estefanía Gómez-Pesquera
    Affiliations
    Department of Surgery, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain

    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Anesthesiology and Resuscitation Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain
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  • Alejandra Fadrique-Fuentes
    Affiliations
    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Anesthesiology and Resuscitation Service, Hospital of Medina del Campo. 24 Peñaranda St, 47400 Medina del Campo (Valladolid), Spain
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  • Pilar Liu
    Affiliations
    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Anesthesiology and Resuscitation Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain
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  • Álvaro Tamayo-Velasco
    Affiliations
    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Hematology and Hemotherapy Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain
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  • Christian Ortega-Loubon
    Affiliations
    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Cardiovascular Surgery Service, Hospital Clinic of Barcelona. 170 Villarroel St, 08036 Barcelona, Spain
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  • Marta Martín-Fernández
    Affiliations
    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Department of Medicine, Dermatology and Toxicology, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain
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  • Hugo Gonzalo-Benito
    Correspondence
    Corresponding author.
    Affiliations
    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Institute of Health Sciences of Castile and Leon (IECSCYL). Santa Clara Sq, 42002 Soria, Spain
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  • Emilio García-Morán
    Affiliations
    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Cardiology Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain
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  • María Heredia-Rodríguez
    Affiliations
    Department of Surgery, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain

    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Anesthesiology and Resuscitation Service, University Hospital of Salamanca. 182 San Vicente Rd, 37007 Salamanca, Spain
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  • Eduardo Tamayo
    Affiliations
    Department of Surgery, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain

    BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain

    Anesthesiology and Resuscitation Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain
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      Highlights

      • Gene expression patterns can distinguish septic shock from non-septic shock.
      • Differentially expressed genes were IGHG1, IL1R2, LCN2, LTF, MMP8, and OLFM4.
      • This tool allows a correct diagnosis to provide an immediate and specific treatment.

      Abstract

      Objectives

      To obtain a gene expression signature to distinguish between septic shock and non-septic shock in postoperative patients, since patients with both conditions show similar signs and symptoms.

      Methods

      Differentially expressed genes were selected by microarray analysis in the discovery cohort. These genes were evaluated by quantitative real time polymerase chain reactions in the validation cohort to determine their reliability and predictive capacity by receiver operating characteristic curve analysis.

      Results

      Differentially expressed genes selected were IGHG1, IL1R2, LCN2, LTF, MMP8, and OLFM4. The multivariate regression model for gene expression presented an area under the curve value of 0.922. These genes were able to discern between both shock conditions better than other biomarkers used for diagnosis of these conditions, such as procalcitonin (0.589), C-reactive protein (0.705), or neutrophils (0.605).

      Conclusions

      Gene expression patterns provided a robust tool to distinguish septic shock from non-septic shock postsurgical patients and shows the potential to provide an immediate and specific treatment, avoiding the unnecessary use of broad-spectrum antibiotics and the development of antimicrobial resistance, secondary infections and increase health care costs.

      Keywords

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