ABO blood types and sepsis mortality

Itenov, Theis Skovsgaard; Sessler, Daniel I.; Khanna, Ashish K.; Ostrowski, Sisse Rye; Johansson, Pär I.; Erikstrup, Christian; Pedersen, Ole Birger; Rygård, Sofie Louise; Holst, Lars Broksø; Bestle, Morten H.; Hein, Lars; Lindhardt, Anne; Tousi, Hami; Andersen, Mads; Mohr, Thomas; Lundgren, Jens D

doi:10.1186/s13613-021-00844-2

Cited by 6 publications

(6 citation statements)

References 22 publications

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“…In two separate studies, Reilly et al demonstrated that blood group A is associated with increased risk for ARDS in sepsis and trauma, possibly due to dysfunction of endothelium and microvasculature, as indicated by altered levels of biomarkers (e.g., soluble thrombomodulin and selectins) [ 14 , 15 ]. These findings are supported by results from a large study of critically ill sepsis patients evaluating the ABO blood group and biomarkers of endothelial damage, which demonstrated moderately decreased mortality for blood group B [ 12 ]. In the present study, the potential effect of the ABO-blood group did not influence morbidity and mortality outcomes for any of the sepsis ( n = 3016), septic shock ( n = 1366) or ARDS ( n = 5642) subgroups.…”

Section: Discussionmentioning

confidence: 54%

ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients

et al. 2022

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Background The ABO and RhD blood group represent antigens on the surface of erythrocytes. The ABO blood group antigens are also present on multiple other cells. Interestingly, previous studies have demonstrated associations between the blood group and many types of disease. The present study aimed to identifying associations between the ABO blood group, the RhD blood group, and morbidity and mortality in a mixed cohort and in six pre-defined subgroups of critically ill patients. Methods Adult patients admitted to any of the five intensive care units (ICUs) in the Scania Region, Sweden, between February 2007 and April 2021 were eligible for inclusion. The outcomes were mortality analysed at 28– and 90–days as well as at the end of observation and morbidity measured using days alive and free of (DAF) invasive ventilation (DAF ventilation) and DAF circulatory support, including vasopressors or inotropes (DAF circulation), maximum Sequential Organ Failure Assessment score (SOFAmax) the first 28 days after admission and length of stay. All outcomes were analysed in separate multivariable regression models adjusted for age and sex. In addition, in a sensitivity analysis, five subgroups of patients with the main diagnoses sepsis, septic shock, acute respiratory distress syndrome, cardiac arrest and trauma were analysed using the same separate multivariable regression models. Results In total, 29,512 unique patients were included in the analyses. There were no significant differences for any of the outcomes between non-O blood groups and blood group O, or between RhD blood groups. In the sensitivity analysis of subgroups, there were no differences in mortality between non-O blood groups and blood group O or between the RhD blood groups. AB was the most common blood group in the COVID-19 cohort. Conclusions The ABO and RhD blood group do not influence mortality or morbidity in a general critically ill patient population.

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Section: Discussionmentioning

confidence: 54%

ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients

et al. 2022

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“…The in uence of ABO blood types on the release of endothelial cell injury molecules can have a substantial effect on the occurrence of organ failure in sepsis. The expression of markers indicating endothelial cell damage, such as sTM, syndecan-1, and sICAM-1, was found to be lower in patients with blood type B compared to those with other blood types 10,16 . This could explain that septic patients with blood type B had a lower frequency of newly d/eOD within 7 days after admission to ICU.…”

Section: Discussionmentioning

confidence: 87%

“…One possible explanation is that patients with blood type O tend to have plasma vWF levels that are 25-30% lower than those with other blood types, thereby impairing sepsisrelated coagulation and immunological responses 9 . However, a retrospective study conducted in Denmark revealed that septic patients with blood type B exhibited a slightly lower risk of 30-day mortality compared to septic patients with non-B blood type, which can be attributed to reduced endotheliumdamage 10 . To date, there is a scarcity of research investing the relationship between ABO blood type and the occurrence of organ dysfunction during the early stages of sepsis.…”

Section: Introductionmentioning

confidence: 97%

“…The ndings revealed that patients with blood type B exhibited slightly lower 28-day and 90-day mortality compared to patients with other blood types18 . Additionally, another investigation focusing on ABO blood type and mortality in patients with sepsis, which enrolled 12,342 patients with serious sepsis, demonstrated that patients with blood type B experienced reduced 30-day mortality than those with other blood types10 . Although the aforementioned research did not employ statistical comparisons between blood type B and non-B blood types, it is noteworthy to highlight the observed decrease in mortality among patients with blood types B.…”

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confidence: 99%

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Impact of ABO blood type on morbidity of organ dysfunction and mortality in septic patients: a single center retrospective observational study

ZHENG,

JIN,

ZHANG

et al. 2024

Preprint

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Background Sepsis is a life-threatening organ dysfunction caused by dysregulated host immune response to infection. The relationship between ABO blood type and the occurrence of organ dysfunction the initial stages of sepsis and 28-day mortality has rarely been reported. This study aims to explore the potential association between ABO blood type and the incidence of organ dysfunction and 28-day mortality. This study was a single-center retrospective observational analysis, encompassing all septic patients admitted to our ICU from 2015 to 2021. Various patient characteristics were recorded. Results A total of 184 patients diagnosed with sepsis were enrolled in the study, with 166 meeting the specified inclusion criteria. The finding revealed a significant association between d/eOD and ABO blood type. Specifically, individuals with blood type B demonstrated the lowest incidence of d/eOD. Consequently, the septic patients were divided into two groups: blood type B and non-B blood types. Compared to non-B blood types, blood type B exhibited a lower incidence of d/eOD within 7-day (43.40% vs 26.67%, P = 0.03) and 28-day mortality (52.83% vs 26.67%, P < 0.00). Multivariate Cox regression analysis showed that both blood type B [HR 0.42, 95% CI (0.24–0.74), P < 0.01] and SOFA score [HR 1.14, 95% CI (1.05–1.24), P < 0.01] were associated with 28-day mortality. Additionally, blood type B was found to be an independent factor protecting against d/eOD [OR 0.48, 95% CI (0.24–0.96), P = 0.04]. Conclusion Blood type B has been found to a protective factor in the incidence of d/eOD during early-stage sepsis and 28-day mortality for septic patients.

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“…A recent study found that Japanese patients with O-type blood also experience higher mortality rates while undergoing treatment for septic shock compared to patients with other blood types. 17 However, attempts to replicate these results in other patient populations have been unsuccessful. For example, Kander et al reported one of the largest studies on the influence of ABO and RhD blood groups on mortality, including 29,512 patients in five subgroups with the main diagnoses of sepsis, septic shock, acute respiratory distress syndrome, cardiac arrest, and trauma.…”

Section: Discussionmentioning

confidence: 99%

Type-O Blood Is Not Associated With Elevated Mortality After Trauma: A North American Cohort Study

Kwasny,

Adams,

Bovio

et al. 2023

The American Surgeon™

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Background Recent studies have presented contradictory findings on the relationship between blood type and mortality in trauma patients. Using the largest population in a study of this type to date, we hypothesized that ABO genotype and Rhesus status would influence trauma-related mortality and morbidity given the relationship between blood type and hemostasis. Methods Data from all trauma patients admitted to level I and level II trauma centers in one city over a five-year period was retrospectively analyzed. Patients were stratified by ABO type. Patient demographics and outcomes were then assessed. Chi-squared and Fisher’s exact tests were used to analyze categorical variables. Continuous variables were analyzed using ANOVA or Kruskal-Wallis tests as appropriate. Logistic regression was used to determine independent associations for 28-day mortality and complications. Results Of 5249 patients, severe injury (ISS >15) was present in 1469. Approximately one-quarter of patients with severe injury received blood products within the first 24 hours. There were no significant variations in demographics or complications between patients of different blood types. Univariate and multivariable regression analysis showed no association between blood type and mortality. However, penetrating injury, lower GCS, higher ISS, blood transfusion within 24 hours, and Asian descent were associated with higher overall mortality. Conclusions In contrast to previous studies, we found no evidence of an association between blood type and mortality. However, our findings suggest that patients of Asian descent may be at higher risk for mortality following trauma. Further research is warranted to explore this observation.

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ABO blood types and sepsis mortality

Cited by 6 publications

References 22 publications

ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients

ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients

Impact of ABO blood type on morbidity of organ dysfunction and mortality in septic patients: a single center retrospective observational study

Type-O Blood Is Not Associated With Elevated Mortality After Trauma: A North American Cohort Study

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