Association between clinical attributes and gene expression



Introduction and Background

On this page, it is possible to directly look at a clinical attribute and relate it to differences in the expression of individual genes. Here, clinical attributes are correlated to changes in gene expression over time.

Whole blood leukocyte gene expression was determined in 167 adult patients with severe blunt trauma over 28 days and 37 healthy control subjects. Clinical attributes were also collected making it possible to associate different patterns of gene expression with individual clinical attributes. The clinical attributes have been broken down into demographics, characteristics and severity of the injury, and outcomes, as described in the J Exp Med publication. Additionally, study subjects have been further stratified into those patients with uncomplicated and complicated recoveries making it possible to follow the clinical attributes and temporal gene expression of each group based on multi-organ system failure and time to recovery.


Instructions

Click on an attribute to view detailed information about this attribute and links to how this clinical attribute associates with genomic expression. The attributes below have been subdivided into demographics, injury characteristics, and outcomes.


Demographics

Age, in years, between 16 and 55 years
Sex, male or female


Injury Characteristics

Max AIS score not including head injury, (AIS) Abbreviated Injury Scale is an anatomic based injury severity scoring system. A number, 1-6, is assigned per anatomic region with larger numbers indicating increased injury. Anatomic regions include head and neck, face, chest, abdomen, extremity, and spine.

Injury severity score, (ISS) Injury Severity Score is an anatomic based injury severity scoring system that is based on the AIS score (see above). The 3 highest body region scores of the AIS are squared and then added together to produce a value from 0-75. If there is any injury in the AIS that is a 6 indicative of an unsurvivable injury, the ISS score is automatically designated to be 75.

Emergency Department lowest systolic blood pressure, The patient’s lowest systolic blood pressure recorded in the ER during resuscitation in mmHg.

Emergency Department Base deficit, The patient’s worst base deficit recorded during the first 6 hours of resuscitation. Base deficit represents the accumulation of blood products (organic acids) indicative of inadequate resuscitation, perfusion and hypoxia. A measure of the severity of the injury.

Transfused blood 0-12 hours since injury, The total volume of blood products that the patient received in milliliters during the first 12 hours post injury.

APACHE II Score, Acute Physiology And Chronic Health Evaluation II is one of many disease severity scoring systems. An integer score from 0-71 is assigned during the first 24 hours of admission to an ICU and is based on clinical parameters such as blood pressure, temperature, and heart rate. The higher the score the more severe the physiological abnormalities.


Outcomes

Uncomplicated Recovery (Yes/No/Other), A categorical variable defining whether the patient’s recovery could be classified as being uncomplicated or not. An uncomplicated recovery was defined as maximum MOF < 6 and <= 5 days to MOF recovery. Complicated recovery was defined as maximum MOF > 6 and >=14 days to MOF recovery (Marshall score of 0).

Nosocomial Infection (Y/N), Nosocomial infections that occurred during the hospital admission after injury such as urinary tract infections, ventilator associated pneumonia, and surgical site infections.

Surgical site infections (Y/N), Surgical site infections during the hospital admission after injury.

Maximum MOF (Marshall score), The classic Marshall score is one of many disease severity scoring systems that includes 6 organ components: respiratory, renal, hepatic, cardiovascular, hematologic, and neurologic evaluation. For the present study, the neurologic component was excluded. The values represent the sum of 5 organ components with higher numbers representing increased organ dysfunction. Measured daily - maximum recorded daily value

Time to Recovery, These values represent the length of time in days for a given patient to return to an absence of organ failure.

ICU total length of stay, The total intensive care unit length of stay in days.

Hospital length of stay, The total hospital length of stay in days.

Survival (Y/N), 28 day patient survival after severe blunt trauma.

Disclaimers

The complete dataset contains over 160 additional clinical attributes that are both time dependent and independent, as well as calculated fields. Access to the entire clinical dataset is restricted to consortium members, and requires IRB approval from your local institution. For further information regarding consortium membership and complete access to the database, go to www.gluegrant.org




Data and Analysis Description

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