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Original Research: Critical Care |

ABO Blood Type A Is Associated With Increased Risk of ARDS in Whites Following Both Major Trauma and Severe SepsisABO Blood Type A Increases ARDS Risk

John P. Reilly, MD; Nuala J. Meyer, MD, FCCP; Michael G. S. Shashaty, MD; Rui Feng, PhD; Paul N. Lanken, MD, FCCP; Robert Gallop, PhD; Sandra Kaplan, BSN; Maximilian Herlim; Nathaniel L. Oz, BS; Isabel Hiciano, BA; Ana Campbell, MD; Daniel N. Holena, MD; Muredach P. Reilly, MBBCh; Jason D. Christie, MD
Author and Funding Information

From the Division of Pulmonary, Allergy, and Critical Care (Drs J. P. Reilly, Meyer, Shashaty, Lanken, Campbell, and Christie; Mss Kaplan and Hiciano; and Mr Oz), Center for Clinical Epidemiology and Biostatistics (Drs J. P. Reilly, Shashaty, Feng, Gallop, and Christie and Mr Herlim), Division of Traumatology, Surgical Critical Care, and Emergency Surgery (Dr Holena), and Penn Cardiovascular Institute (Dr M. P. Reilly), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

Correspondence to: John P. Reilly, MD, Perelman School of Medicine at the University of Pennsylvania, 844 W Gates Bldg, 3600 Spruce St, Philadelphia, PA 19104; e-mail: John.Reilly@uphs.upenn.edu


Part of this article has been presented in abstract form at the American Thoracic Society 2012 International Conference, May 18-23, 2012, San Francisco, CA (Reilly JP, Meyer NJ, Feng R, et al. Am J Respir Crit Care Med. 2012;185:A1153), and the American Thoracic Society 2013 International Conference, May 17-22, 2013, Philadelphia, PA (Reilly JP, Shashaty MGS, Herlim M, et al. Am J Respir Crit Care Med. 2013;187:A2226).

Funding/Support: Funding was provided by the National Institutes of Health [Grants P50-HL60290, P01-HL079063, U01-HL108636, R01-HL081619, K23-HL102254, K24-HL115354, T32-HL007891, and K23-DK097307].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(4):753-761. doi:10.1378/chest.13-1962
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Background:  ABO glycosyltransferases catalyze antigen modifications on various glycans and glycoproteins and determine the ABO blood types. Blood type A has been associated with increased risk of vascular diseases and differential circulating levels of proteins related to inflammation and endothelial function. The objective of this study was to determine the association of ABO blood types with ARDS risk in patients with major trauma and severe sepsis.

Methods:  We conducted prospective cohort studies in two populations at an urban tertiary referral, level I trauma center. Critically ill patients (n = 732) presenting after major trauma were followed for 5 days for ARDS development. Additionally, 976 medical patients with severe sepsis were followed for 5 days for ARDS. Multivariable logistic regression was used to adjust for confounders.

Results:  ARDS developed in 197 of the 732 trauma patients (27%). Blood type A was associated with increased ARDS risk among whites (37% vs 24%; adjusted OR, 1.88; 95% CI, 1.14-3.12; P = .014), but not blacks (adjusted OR, 0.61; 95% CI, 0.33-1.13; P = .114). ARDS developed in 222 of the 976 patients with severe sepsis (23%). Blood type A was also associated with an increased ARDS risk among whites (31% vs 21%; adjusted OR, 1.67; 95% CI, 1.08-2.59; P = .021) but, again, not among blacks (adjusted OR, 1.17; 95% CI, 0.59-2.33; P = .652).

Conclusions:  Blood type A is associated with an increased risk of ARDS in white patients with major trauma and severe sepsis. These results suggest a role for ABO glycans and glycosyltransferases in ARDS susceptibility.

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