A Transcriptomic Approach to Understand Patient Susceptibility to Pneumonia After Abdominal Surgery
Authors' conclusion
Major abdominal surgery acutely upregulates innate-immune pathways while simultaneously suppressing adaptive-immune pathways. This is more prominent in patients developing postoperative pneumonia.
Study context
- Population
- Patients undergoing major abdominal surgery; whole-blood RNA preoperatively and 2–6, 24 and 48 h postoperativelyprospective consecutive cohort
- Participants
- 150 patients
- Comparison
- Postoperative pneumonia vs matched infection-free patients
- Pneumonian = 12
- Infection-freen = 27reference
- Outcome
- Transcriptomic changes after surgery and patterns associated with postoperative pneumonia
Methodological detailsprospective consecutive cohort, matched controls, RNA-sequencing, external validation cohorts
- Prospective consecutive cohort
- Matched controls
- RNA-sequencing
- External validation cohorts
Main finding
As reported in the abstract
- Genes upregulated at 2 to 6 h vs preoperative
- 3639
- Genes downregulated at 2 to 6 h vs preoperative
- 5043
- Preoperative neutrophil degranulation gene-signature associated with postoperative pneumonia
- P =0.00092
- SRSq score at 48 h differed between pneumonia and infection-free patients
- P =0.045
Observational data: associations, not effects.
Further findings
External validation (independent major abdominal surgery and polytrauma cohorts)
- Neutrophil gene-signature and SRSq scores showed good predictive performance for later infection
Original publication
A Transcriptomic Approach to Understand Patient Susceptibility to Pneumonia After Abdominal Surgery. Ann Surg. Published 27 July 2023. doi:10.
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