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. 2014 Apr;145(4):753-761.
doi: 10.1378/chest.13-1962.

ABO blood type A is associated with increased risk of ARDS in whites following both major trauma and severe sepsis

John P Reilly  1 , Nuala J Meyer  2 , Michael G S Shashaty  3 , Rui Feng  4 , Paul N Lanken  2 , Robert Gallop  4 , Sandra Kaplan  2 , Maximilian Herlim  4 , Nathaniel L Oz  2 , Isabel Hiciano  2 , Ana Campbell  2 , Daniel N Holena  5 , Muredach P Reilly  6 , Jason D Christie  3
Affiliations

ABO blood type A is associated with increased risk of ARDS in whites following both major trauma and severe sepsis

John P Reilly et al. Chest. 2014 Apr.

Abstract

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 5 732) 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 5 .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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Figures

Figure 1.
Figure 1.
Screening and enrollment. A, Trauma cohort. B, Sepsis cohort.
Figure 2.
Figure 2.
Frequency of ARDS by ABO blood type in trauma. A, White (n = 335) subjects. B, Black (n = 370) subjects. Numbers at the top of each bar represent the total number of patients with each blood type. P values determined by unadjusted Pearson χ2 test.
Figure 3.
Figure 3.
Frequency of ARDS by ABO blood type in severe sepsis. A, White (n = 544) subjects. B, Black (n = 341) subjects. Numbers at the top of each bar represent the total number of patients with each blood type. P values determined by unadjusted Pearson χ2 test.
See this image and copyright information in PMC

Comment in

  • ABO blood type and ARDS.
    Zhan Y. Zhan Y. Chest. 2015 Feb;147(2):e67. doi: 10.1378/chest.14-2491. Chest. 2015. PMID: 25644927 No abstract available.
  • Response.
    Reilly JP, Christie JD. Reilly JP, et al. Chest. 2015 Feb;147(2):e67-e68. doi: 10.1378/chest.14-2627. Chest. 2015. PMID: 25644928 No abstract available.

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