Genetic Variation in Trauma Patients : Sequence Variations in Innate Immune Response Genes Influence Outcome

Millions of people die every year as a result of injuries. This accounts for 10% of the world’s deaths, 32% more than the number of fatalities that result from malaria, tuberculosis, and HIV/AIDS combined. A quarter of these deaths are caused by road traffic accidents and one third are the cause of violence (homicide, suicide and war casualties). A number of injured patients will die at the accident scene or in the first few hours after trauma (the so-called Golden hour). But when victims have survived these first few hours and have made it to an Intensive Care Unit (ICU) recovery can be compromised by conditions such as Systemic Inflammatory Response Syndrome (SIRS), Acute Respiratory Distress Syndrome (ARDS), sepsis, septic shock or mortality. Even when death can be prevented, infectious complications can give rise to increased morbidity and cost of care. The outcome of trauma is determined by the severity of the injury, by the quality of medical or surgical care delivered and by host factors. Known host risk factors are age, gender and co-morbidity. But it is also known that genomic sequence variations can influence the course and outcome of a disease. The aim of this thesis was to study the associations between genomic sequence variations in severely injured patients and infectious outcome parameters during hospital stay