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

Impact of ABO blood type on morbidity of organ dysfunction and mortality in septic patients: a single center retrospective observational study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Impact of ABO blood type on morbidity of organ dysfunction and mortality in septic patients: a single center retrospective observational study HongZhu ZHENG, HuiYong JIN, Qian ZHANG, Haijing SONG, LingXian YI This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3917942/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract 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. Sepsis SOFA score Organ failure Blood type Mortality Morbidity Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Sepsis is characterized as an aberrant host reaction to infection, resulting in potentially fatal dysfunction of vital organs, primarily affecting the cardiovascular, pulmonary, renal, and cerebral system. The presence and severity of single and multiple organ dysfunction play a crucial role in determining the severity of illness and prognosis in septic patients. In the intensive care unit (ICU), sepsis represents a major cause of mortality, with rates ranging from 20–30% and even reaching 50% in patients of septic shock. Despite extensive research efforts spanning several decades, the underlying mechanism of sepsis remains incompletely comprehended. Gene polymorphisms have been found to exhibit a strong correlation with the severity of illness and prognosis of sepsis due to their involvement in hyperinflammatory responses, immune dysfunction, endothelial cell dysfunction, and other related pathological process. The polymorphisms can impact microbial susceptibility, the production and release of inflammatory factors, as well as endothelia cell damage or activation and immune function. ABO blood type is a stable genetic information which is expressed not only erythrocytes but also on various other cells and tissues, including leukocytes, platelets, vascular endothelial cells, and epithelial cells 1 . ABO antigens serve multiple functions, such as acting receptors for viruses, bacteria, parasites, adhesion molecules, structural proteins, and enzymes 2 . Genetic variations in the ABO blood type result in differences in host-pathogen interactions, which is to say varying susceptibilities of pathogenic microbes have a strong relationship to different blood types. Previous research has indicated that individuals with blood type O may have a heightened vulnerability to cholera, plague, and tuberculosis. Conversely, blood type A has been associated with a higher occurrence of smallpox and Pseudomonas aeruginosa infection. Blood type B, on the other hand, has been found to be correlated with an increased prevalence of gonorrhea, tuberculosis, Streptococcus pneumoniae, Escherichia coli, and Salmonella infections. Lastly, blood type AB has been linked to an elevated incidence of smallpox, Escherichia coli, and Salmonella infections 3 . Moreover, ABO antigens have been shown to have an impact on the synthesis of various glycoproteins within the circulatory system, specifically those derived from endothelial cells. Those glycoproteins, such as von Willebrand factor (VWF), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble thrombomodulin (sTM), serve as indicators for assessing vascular endothelial cell damage 4 – 7 . It is worth noting that the polymorphism of the ABO blood group can result in varying susceptibilities to pathogenic microorganisms, consequently leading to different degrees of infection in the host. ABO antigens existing on the surface of vascular endothelial cells (VECs) can exert an influence on the functionality of VECs. The susceptibility of pathogenic microorganism, as well as the functionality of VECs, can both play a role in determining the prognosis of septic patients. In recent times, several inquiries have been conducted regarding the correlation between ABO blood type and mortality among septic patients. A subset of septic shock patients with blood type O showed increased 90-day mortality but no influence on 28-day mortality in a Japan study on ABO blood types and mortality in septic patients 8 . 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 sepsis-related 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. Nevertheless, a study involving critically ill patients with trauma and sepsis, has indicated that blood type A is associated with a higher prevalence of acute kidney injury (AKI) and acute respiratory distress syndrome (ARDS) in a subset of individuals of European ancestry 11 , 12 . Therefore, a single-center retrospective observation study was undertaken to examine the relationship between ABO blood types and the occurrence of organ dysfunction and mortality in septic patients, so as to provide a reference for the enhanced clinical management of septic patients with varying ABO blood types. Material and methods Patient and data This was a retrospective observational study that included all patients admitted to the Department of intensive critical unit of the Chinese People's Liberation Army Strategic Support Forces Specialized Medical Center from 1 January 2015 to 31 December 2021. Inclusion criteria were as follows: 1. patients were elder than 16 years old. 2. Sepsis diagnosis criteria according to The Third International Consensus Definitions for Sepsis and Septic Shock(Sepsis 3.0): sepsis was classified as infection plus sequential organ failure (SOFA score ≥ 2) 13 . ΔSOFA is the difference in SOFA score before and after sepsis diagnosis. Exclusion criteria: 1. Patients were younger than 16 years. 2. The patient who admitted to the ICU more than one time during hospital admission was counted only once. 3. The patient and their family give up treatment. 4. Patients with blood type were absented. The following information was retrospectively collected from medical records: age, gender, blood type, major underlying disease, Acute Physiology and Chronic Health Status Scoring System II (APACHE II) score, Sequential (Sepsis- related) Organ Failure Assessment (SOFA) score, values of each SOFA score within 7 days after admission to ICU, source of infection, and 28-day mortality (patients discharged within 28 days were confirmed as survivors). Definitions A newly “developed or exacerbated organ dysfunction” (d/eOD) was defined as previously research. Briefly, the newly “d/eOD” was defined as a net increase in SOFA score ≥ 2 of at least one organ within 7 days after admission in ICU over the baseline (SOFA score in the first 24h) 14 . The worst SOFA was adopted after diagnosed sepsis from the second 24h until day 7. The primary outcome measures were the incidence of newly “d/eOD” and 28-day mortality. Statistical analysis The data was statistically analyzed using SPSS 19.0 statistical software. Continuous variables were presented as mean ± standard deviation (x ± s); independent samples t-test was used to compare the differences between groups. Categorical variables were depicted as the number of groups (the number of percentages) and chi-squared test or Fisher’s exact test was used for comparison among groups. Multifactorial logistic regression and COX regression analyses were employed to assess the effects of different groups on the incidence of organ dysfunction and 28-day mortality. P < 0.05 was considered a significant difference. Results 1.The distribution of ABO blood types for patients with sepsis A cohort of 184 septic patients were admitted to our ICU during the period from 2015-01-01 to 2021-12-31. Among them, 14 patients lacked information regarding their blood type, and 4 patients had multiple admissions. Consequently, 166 septic patients were eligible for inclusion in this study, as determined the established exclusion criteria (Fig. 1 ). 2. Baseline characteristics and 28-day mortality in sepsis patients with newly d/eOD As shown in Table 1 , there was a significant association between the occurrence of newly d/eOD within 7 days after admission to ICU and blood type(P < 0.05). However no significant correlation was observed between this incidence and factors such as gender, age, APACHE II score and SOFA score within 24 hours of admission, comorbidity, or cause of infection. The data showed that septic patients with blood type AB exhibited the highest incidence of newly d/eOD within 7 days, with a rate of 62.50%. Conversely, patients with blood type B displayed the lowest incidence at 26.67%. Furthermore, patients with blood type O demonstrated a significantly elevated prevalence of hematologic and cardiovascular dysfunction compared to those with blood type B (P < 0.05). Similarly, septic patients with blood type AB exhibited a significantly higher occurrence of liver dysfunction in comparison to patients with blood type O and A (P < 0.05). (Fig. 2 ). Interestingly, the study revealed that the 28-day mortality rate in septic patients with newly d/eOD within 7 days was slightly higher compared to those with non-newly d/eOD, although the observed difference did not reach statistical significance (Table 1 ). Table 1 Baseline characteristics in septic patients with and without newly d/eOD Clinical variables d/eOD non-d/eOD P -value Gender 0.68 Male n(%) 41(66.13) 72(69.23) Female n(%) 21(33.87) 32(30.77) Age 79.87 ± 11.94 78.42 ± 10.83 0.37 APACHE II score 21.32 ± 6.14 21.83 ± 6.53 0.69 SOFA score 7.97 ± 3.22 8.37 ± 3.38 0.41 Comorbidities Coronary Artery Disease n(%) 20(32.26) 37(35.58) 0.66 Cardiac insufficiency n(%) 2(3.23) 1(0.96) 0.29 Diabetes n(%) 18(29.03) 39(37.50) 0.27 Hypertension n(%) 29(46.77) 62(59.62) 0.11 Malignancy n(%) 7(11.29) 4(3.85) 0.06 Cerebrovascular disease n(%) 13(20.97) 22(21.15) 0.98 Source of infection Respiratory system n(%) 47(75.81) 71(68.27) 0.30 Abdominal n(%) 6(9.68) 12(11.54) 0.71 Intravascular catheter n(%) 3(4.84) 5(4.81) 0.99 Uriary n(%) 2(3.23) 5(4.81) 0.62 Others n(%) 3(4.84) 11(10.58) 0.20 Blood type 0.00 O n(%) 22(35.48) 35(33.65) A n(%) 14(22.58) 19(18.27) B n(%) 16(25.81) 44(42.31) AB n(%) 10(16.13) 6(5.77) 28-day mortality (%) 48.39 40.38 0.31 Abbreviations :d/eOD, developed or exacerbated organ dysfunction; APACHE II score, Acute Physiology and Chronic Health Status Scoring System II score; SOFA score, Sequential (Sepsis- related) Organ Failure Assessment (SOFA) score. 3. Baseline characteristics and outcomes in different ABO blood type in septic patients Because the occurrence of newly d/eOD might be associated with ABO blood type, the patients were divided to four groups based on ABO blood type: 57 patients with blood type O (34.34%), 33 patients with blood type A (19.88%), 60 patients with blood type B (36.14%), and 16 patients with blood type AB (9.64%) (Fig. 1 , Table 1 ). The distribution of ABO blood type observed in this study was found to be similar to that of the general Chinese population ( http://www.bloodlook.com/world-abo.html ). The baseline characteristics of patients with sepsis and outcome according to the ABO blood type were showed in Table 2 . Significant variations were observed in age, SOFA score, complications of malignancy, and infection originating from the abdomen among the four groups ( P < 0.05), while other clinical characteristics exhibited similar distribution. The chi-squared test revealed that septic patients with blood type B exhibited significantly lower 28-day mortality ( P < 0.05) and a lower incidence of new d/eOD within 7 days ( P = 0.05) compared to the other groups (Table 2 ). The differences in outcomes between septic patients with blood type B and non-B were further analyzed. Table 2 Baseline characteristics of septic patients with different ABO blood types Blood Type O (n = 57) A (n = 33) B (n = 60) AB (n = 16) P -value Male n(%) 42(73.68) 21(63.64) 40(66.67) 10(62.50) 0.701 Age 79.8 ± 10.12 81.49 ± 9.88 80.40 ± 10.84 81.78 ± 9.57 0.00 APACHE II score 21.61 ± 6.39 22.15 ± 7.63 21.63 ± 5.70 25.8 ± 4.72 0.15 SOFA score 7.95 ± 3.46 7.73 ± 2.76 8.31 ± 3.36 9.24 ± 3.15 0.00 Comorbidities Coronary Artery Disease n(%) 14(24.56) 11(33.33) 26(43.33) 6(37.50) 0.13 Cardiac insufficiency n(%) 1(1.75) 0(0) 2(3.33) 0(0) 0.64 Diabetes n(%) 17(29.82) 12(36.36) 24(40.00) 4(25.00) 0.48 Hypertension n(%) 31(54.39) 18(54.54) 34(56.67) 8(50.00) 0.96 Malignancy n(%) 3(5.26) 6(18.18) 2(3.33) 0(0) 0.02 Cerebrovascular disease n(%) 13(22.81) 9(27.27) 10(16.67) 3(18.75) 0.61 Source of infection Respiratory system n(%) 43(75.44) 20(60.61) 44(73.33) 11(68.75) 0.30 Abdominal n(%) 4(7.02) 8(24.24) 3(5.00) 3(18.75) 0.01 Intravascular catheter n(%) 3(5.26) 2(6.06) 3(5.00) 0(0) 0.81 Uriary n(%) 2(3.51) 1(3.03) 3(5.00) 1(6.25) 0.74 Others n(%) 5(8.77) 2(6.06) 7(11.67) 2(12.50) 0.80 28-day mortality (%) 52.63 51.51 26.67 56.25 0.00 d/eOD (%) 38.60 42.42 26.67 62.50 0.05 4. Baseline characteristics and outcomes between blood type B and non-B in septic patients The baseline characteristics of septic patients with blood type B were found to be similar distributed compared to those with non-B blood type. Interestingly, compared with those with non-B blood type, septic patients with blood type B exhibited a lower 28-day mortality rate and a lower incidence of new d/eOD within 7 days ( P < 0.05) (Table 3 ). The data also revealed that septic patients with non-B blood type had a higher total ΔSOFA score within 7 days after admission to ICU. However, there was no statistically significant difference observed in the occurrence of single organ dysfunction in the respiratory, hematological, hepatic, cardiovascular, neurological, and renal systems between blood type B patients and non-B blood type patients ( P > 0.05) (Fig. 3 ). Table 3 Baseline characteristics of septic patients with blood type B and those with non- B blood type Blood type B (n = 60) Non-B (n = 106) P -value Male n(%) 40(66.67) 73(68.87) 0.77 Age 80.40 ± 10.84 79.16 ± 10.85 0.76 APACHE II score 21.63 ± 5.70 22.41 ± 6.69 0.45 SOFA score 8.31 ± 3.36 8.11 ± 3.30 0.59 Comorbidities Coronary artery disease n(%) 26(43.33) 31(29.25) 0.07 Cardiac insufficiency n(%) 2(3.33) 1(0.94) 0.27 Diabetes mellitus n(%) 24(40.00) 33(31.13) 0.25 Hypertension n(%) 34(56.67) 57(53.77) 0.72 Malignancy n(%) 2(3.33) 9(8.49) 0.20 Cerebrovascular disease n(%) 10(16.67) 25(23.58) 0.29 Source of infection Respiratory system n(%) 44(73.33) 74(69.81) 0.63 Abdominal n(%) 3(5.00) 15(14.15) 0.07 Intravascular catheterization n(%) 3(5.00) 5(4.72) 0.94 Uriary n(%) 3(5.00) 4(3.77) 0.71 Others n(%) 7(11.67) 7(6.60) 0.26 28-day mortality (%) 26.67 52.83 0.00 d/eOD (%) 26.67 43.40 0.03 5. Association between blood type B and 28-day mortality in septic patients Age, gender, APACHE II score, and SOFA score are known to as common factors that influence disease morbidity and mortality. In our study, we included those variables in the COX regression analysis and observed that blood type B and SOFA score were significantly associated with 28-day mortality in septic patients (HR 0.42; 95% CI 0.24–0.74; P < 0.05). (Fig. 4 ). However, we found that 28-day mortality was not associated with APACHE II score, age and gender (Fig. 4 ). 6. Impact of blood type B on the risk potential of newly d/eOD in septic patients The finding from our analysis of data in Table 1 and Table 3 indicate a significant association between ABO blood type and the occurrence of newly d/eOD. In order to further investigate the potential of blood type B in reducing the risk of new D/eOD, we conducted a multivariate logistic regression analysis. This analysis revealed that blood type B was independently linked to a lower frequency of d/eOD (OR 0.48; 95% CI 0.24–0.96; P < 0.05). However, Variables such as SOFA score, APACHE II score, gender and age did not show a significant correlation with newly d/eOD within 7 days after admission to ICU (Fig. 5 ). Discussion This study, conducted retrospectively at a single center, revealed that septic patients with blood type B, admitted to the intensive care unit, exhibited a notably lower 28-day mortality compared to those with non-B blood type. Additionally, the study identified the SOFA score as a significant risk factor influencing 28-day mortality of septic patients. In comparison to individuals with non-B blood type, septic patients with blood type B exhibited a notable reduction in the incidence of newly d/eOD within 7 days after admission in ICU, although there was no statistically significant difference observed in the rate of decline of individual organ dysfunction, encompassing respiratory, hematologic, hepatic, cardiovascular, neurologic, and kidney systems, between septic patients with blood type B and those with blood type non-B. The observed higher survival rate of individuals with blood type B in our study aligns consistently with the findings of a previously conducted large multicenter study in Denmark 10 . In addition, based on our current understanding, this study represents the initial investigation to document correlation between ABO blood type and incidence of organ dysfunction morbidity in septic patients. Despite the unalterable nature of patients’ ABO blood type as an inherent genetic characteristic, timely and accurate identification of high-risk patients can substantially enhance the morbidity and mortality outcomes associated with organ dysfunction in sepsis. The ABO blood type exhibits a diverse range of characteristics due to variations in antigenic surface monosaccharides. The impact of ABO blood type on organ function is associated with endothelial cell dysfunction, microcirculatory coagulation, and inflammation 12 . ABO blood type antigens play a crucial role in determining the levels of soluble ICAM-1, selectin, vWF, and thrombomodulin in the plasma, which in turn can influence coagulation, cardiovascular, respiratory, and renal function 4 , 5 , 7 , 15 . Patients with blood type O are at an increased risk of bleeding due to a notable decrease in their plasma vWF levels, which are approximately 25–30% lower compared to individuals with non-O blood types. Conversely individuals with non-O blood types exhibited higher plasma concentrations of coagulation factors, including vWF and factor VIII, thereby resulting in an elevated susceptibility to ischemic heart disease and thromboembolic disease when compared to those blood type O 3 . Patients with serious trauma and sepsis who are blood type A have a substantially greater risk of AKI and ARDS than other blood types in European populations. This increasing risk can be attributed to the strong association between blood type A and sTM and vWF 16 . vWF is a large polysaccharide protein primarily synthesized by endothelial cells and released into the bloodstream through Weibel-Palade vesicles, along with other proteins. By attaching to factor VIII, vWF facilitates platelet polymerization and subsequent adhesion to damaged endothelial cells, thereby promoting coagulation. Thrombomodulin, a glycoprotein present on the endothelial cell surface, functions as a receptor for thrombin, thereby enhancing the activation of protein C induced by thrombin and consequently exhibiting an anticoagulant impact. In critically ill patient, thrombomodulin undergoes cleavage and subsequent release from the endothelial cell membrane into the plasma. The influence 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. In a study examining the correlation between ABO blood types and AKI in critically ill patients with trauma or sepsis, the incidence of coagulation dysfunction was found to be substantially reduced in patients with blood type B compared to other blood types 12 . Our investigation also revealed that septic patients with blood type B demonstrated a decreased incidence of organ failure in the respiratory, hematologic, cardiovascular and nervous systems in comparison to those with non-B blood types, although this disparity did not reach statistical significance. Previous research confirms that blood type A is independently associated with AKI risk in patients with severe sepsis of European descent, which different from the results of this study 12 . However, the incidence of ARDS in individuals with severe sepsis and major trauma, encompassing both white and black population, demonstrated a decreased likelihood in patients with blood type B when compared to other blood types, aligning with our results 11 . In our study, we observed a notable decrease in 28-day mortality among septic patients with blood type B compared to those with non-B blood type. This finding may be attributed to a significantly lower incidence of new d/eOD within 7 days in patients with blood type B. Consequently, it suggests a potential association between the genetic information of ABO blood type and the incidence of organ dysfunction and mortality in septic patients. A previous study reported that there was no association between blood types and 30-day mortality in 752 septic patients. However, it was found that individuals with blood type B had a lower mortality compared to those with other blood types 12 . Conversely, a comprehensive retrospective study conducted in Japan revealed that septic patients with blood type B exhibited reduced both 28-day and 90-day mortality when compared to individuals with other blood types 8 . Additionally, a multicenter observational study conducted in Spain reported that patients with blood type B had lower ICU mortality in relation to other blood types in the context of severe hypoxic respiratory failure 17 . A study conducted in Swedish examined the relationship between ABO blood type and morbidity and mortality in critically ill patients. The findings revealed that patients with blood type B exhibited slightly lower 28-day and 90-day mortality compared to patients with other blood types 18 . 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 types 10 . 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. Our research particularly examined mortality among septic patients with blood type B and those with non-B blood types. The finding revealed that patients with blood type B exhibited a reduced occurrence of newly d/eOD and 28-day mortality, indicating that blood type B severs as a protective factor against sepsis. Our study suffers from some flaws. Firstly, in order to validate the findings, it is necessary to include a large sample size as our analysis was based on a retrospective analysis conducted at single center. Furthermore, due to the retrospective nature, there were some data defects that could potentially impact the outcomes. Although the amount of missing data was minimal, with only 14 patients lacking blood type information, it is important to acknowledge this limitation. Additionally, it is worth noting that the severity of disease in our study was notably high, with 66.27% of patients presenting with septic shock. This observation may be attributed to a potential lack of comprehensive understanding of sepsis among medical practitioner, leading to delays in ICU admission. All of the aforementioned factors exerted an impact on the prognosis of patients with sepsis. However, we collected a relatively complete data about 28-day survival and the function of each organ in septic patients, and it was a relatively accurate analysis about the relationship between 28-day mortality and newly d/eOD and ABO blood types in intensive care unit. Conclusion There was a genetic difference in morbidity and mortality among septic patients with ABO blood types in this single-center retrospective observational research. Compared to those with non-B blood type, septic patients with blood type B are associated with a lower incidence of newly d/eOD within 7 days and 28-day mortality. It means that blood type B is a protective factor for sepsis. Declarations Acknowledgments None. Author Contributions Yi Lingxian designed the study protocol and writing the manuscript. Zheng HZ and Jin HY were responsible for data collection. Zhang Q were responsible for statistical analysis. Song HJ helped in drafting the manuscript. All authors reviewed and approved the manuscript. Funding This project was funded in part by grants from the Young Science Foundation of National Natural Science Foundation of China (Grant no.82202404) Availability of data and meterials The data used for this publication are available from the corresponding author on reasonable request. Ethics approval and consent to participate This research project is a retrospective observation study that adheres to the pertinent national laws and regulations. Our committee medical ethics considered that it is no necessity to procure informed consent and ethical approval. Consent for publication Not applicable. Conflicts of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. References Green C. The ABO, Lewis and related blood group antigens; a review of structure and biosynthesis. FEMS Microbiol Immunol . 1989;1:321-30. Cartron JP and Colin Y. 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Rezoagli E, Gatti S, Villa S, Villa G, Muttini S, Rossi F, et al. ABO blood types and major outcomes in patients with acute hypoxaemic respiratory failure: A multicenter retrospective cohort study. PLoS One . 2018;13:e0206403. Kander T, Bjurstrom MF, Frigyesi A, Joud M and Nilsson CU. ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients. BMC Anesthesiol . 2022;22:91. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3917942","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":272366140,"identity":"00a31f47-90ee-4ffa-bf11-1329381aa657","order_by":0,"name":"HongZhu ZHENG","email":"","orcid":"","institution":"Strategic Support Force Characteristic Medical Center of People’s Liberation Army","correspondingAuthor":false,"prefix":"","firstName":"HongZhu","middleName":"","lastName":"ZHENG","suffix":""},{"id":272366141,"identity":"638926df-bf28-4e7d-8b00-e9cde2b890a8","order_by":1,"name":"HuiYong JIN","email":"","orcid":"","institution":"Strategic Support Force Characteristic Medical Center of People’s Liberation Army","correspondingAuthor":false,"prefix":"","firstName":"HuiYong","middleName":"","lastName":"JIN","suffix":""},{"id":272366142,"identity":"ddeb70a3-5792-47a5-bbe0-3684fdcbbfac","order_by":2,"name":"Qian ZHANG","email":"","orcid":"","institution":"Chinese PLA General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Qian","middleName":"","lastName":"ZHANG","suffix":""},{"id":272366143,"identity":"0633ec2d-0731-4ae7-a7a3-089957b3ac88","order_by":3,"name":"Haijing SONG","email":"","orcid":"","institution":"Strategic Support Force Characteristic Medical Center of People’s Liberation Army","correspondingAuthor":false,"prefix":"","firstName":"Haijing","middleName":"","lastName":"SONG","suffix":""},{"id":272366144,"identity":"c51d1f4d-d306-475a-b1ca-209bc685fa01","order_by":4,"name":"LingXian YI","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAuElEQVRIiWNgGAWjYDACdgbmBwkVNjz87A3EamFmYDP4cCZNRrLnAPFaGCRnthy2MbjhQKQOg8M8Bsa8Ded5GG4wMH74mEOUFraEx7w7bvMwzm5glpy5jSgtzAeMec/c5mGWOcDGzEucFsYGad62czxsEglEa2E+IDmz7QAPD9FaJA+zpQEDOZlHgudgM3F+4TveYwyMSjt7++PNBz98JEaLwgE4k7GBCPVAIE+kulEwCkbBKBjJAADCjTYdyU8qJQAAAABJRU5ErkJggg==","orcid":"","institution":"Strategic Support Force Characteristic Medical Center of People’s Liberation Army","correspondingAuthor":true,"prefix":"","firstName":"LingXian","middleName":"","lastName":"YI","suffix":""}],"badges":[],"createdAt":"2024-02-01 15:46:54","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3917942/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3917942/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":51389820,"identity":"3826a704-b2f9-40d4-b57a-84e072223029","added_by":"auto","created_at":"2024-02-20 18:14:55","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":290117,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of patient selection.\u003c/p\u003e","description":"","filename":"image2.png","url":"https://assets-eu.researchsquare.com/files/rs-3917942/v1/77623369b0cda12a75079ef8.png"},{"id":51389818,"identity":"9bff6cab-1850-417d-a8b6-6de7aa30342f","added_by":"auto","created_at":"2024-02-20 18:14:55","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":135841,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of the incidence of newly d/eOD in septic patients with ABO blood type.\u003c/p\u003e\n\u003cp\u003eThe chi-square test was applied to compare the percentages of d/eOD between each two groups; Fisher’s-exact-test was used to compare the percentages of d/eOD within four groups. d/eOD, developed or exacerbated organ dysfunction; Resp, respiration; Coag, coagulation; Cir, circulation; CNS, central nervous system. *, Statistical significant \u003cem\u003eP\u003c/em\u003e-value between two groups. Δ, Statistical significant \u003cem\u003eP\u003c/em\u003e-value within four groups.\u003c/p\u003e","description":"","filename":"image3.png","url":"https://assets-eu.researchsquare.com/files/rs-3917942/v1/ecc2f5ce867bb39cbd2e156f.png"},{"id":51389822,"identity":"4c79678a-3457-4ef6-a62d-a75e43eec9de","added_by":"auto","created_at":"2024-02-20 18:14:55","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":163383,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of the incidence of d/eOD between blood type B and non-B blood type.\u003c/p\u003e\n\u003cp\u003eThe chi-square test was applied to compare the percentages of d/eOD between each two groups; *, Statistical significant \u003cem\u003eP\u003c/em\u003e-value between two groups.\u003c/p\u003e","description":"","filename":"image4.png","url":"https://assets-eu.researchsquare.com/files/rs-3917942/v1/81f7f02dbf43533fdc4c8c50.png"},{"id":51389821,"identity":"8a9ef39e-f22a-461a-bc52-2d5df1f4ddec","added_by":"auto","created_at":"2024-02-20 18:14:55","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":64253,"visible":true,"origin":"","legend":"\u003cp\u003eBlood type B and SOFA score can affect 28-day mortality in septic patients.\u003c/p\u003e\n\u003cp\u003eMultivariable COX regression analysis was used. Variables including blood type B, age, gender, APACHE II score, and SOFA score were applied. HR, hazard ratios. CI, confidence interval.\u003c/p\u003e","description":"","filename":"image5.png","url":"https://assets-eu.researchsquare.com/files/rs-3917942/v1/ef19080d27caf6cb9a50d317.png"},{"id":51389819,"identity":"239f5e81-dfdd-491a-979d-d787c5058757","added_by":"auto","created_at":"2024-02-20 18:14:55","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":66866,"visible":true,"origin":"","legend":"\u003cp\u003eBlood type B can decrease the incidence of newly d/eOD.\u003c/p\u003e\n\u003cp\u003eMultivariable logistic regression was used. Variables including blood type B, age, gender, APACHE II score, and SOFA score were applied. OR, odds ratios.\u003c/p\u003e","description":"","filename":"image6.png","url":"https://assets-eu.researchsquare.com/files/rs-3917942/v1/cae22cddaade6f1c7dbe5f4b.png"},{"id":56846588,"identity":"a6f6174c-c1bd-4d08-8893-7f9764c98321","added_by":"auto","created_at":"2024-05-21 08:12:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1383745,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3917942/v1/af2fa3d7-e67c-45a2-8479-86a1ee57f95c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Impact of ABO blood type on morbidity of organ dysfunction and mortality in septic patients: a single center retrospective observational study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSepsis is characterized as an aberrant host reaction to infection, resulting in potentially fatal dysfunction of vital organs, primarily affecting the cardiovascular, pulmonary, renal, and cerebral system. The presence and severity of single and multiple organ dysfunction play a crucial role in determining the severity of illness and prognosis in septic patients. In the intensive care unit (ICU), sepsis represents a major cause of mortality, with rates ranging from 20\u0026ndash;30% and even reaching 50% in patients of septic shock. Despite extensive research efforts spanning several decades, the underlying mechanism of sepsis remains incompletely comprehended. Gene polymorphisms have been found to exhibit a strong correlation with the severity of illness and prognosis of sepsis due to their involvement in hyperinflammatory responses, immune dysfunction, endothelial cell dysfunction, and other related pathological process. The polymorphisms can impact microbial susceptibility, the production and release of inflammatory factors, as well as endothelia cell damage or activation and immune function.\u003c/p\u003e \u003cp\u003eABO blood type is a stable genetic information which is expressed not only erythrocytes but also on various other cells and tissues, including leukocytes, platelets, vascular endothelial cells, and epithelial cells\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. ABO antigens serve multiple functions, such as acting receptors for viruses, bacteria, parasites, adhesion molecules, structural proteins, and enzymes\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. Genetic variations in the ABO blood type result in differences in host-pathogen interactions, which is to say varying susceptibilities of pathogenic microbes have a strong relationship to different blood types. Previous research has indicated that individuals with blood type O may have a heightened vulnerability to cholera, plague, and tuberculosis. Conversely, blood type A has been associated with a higher occurrence of smallpox and Pseudomonas aeruginosa infection. Blood type B, on the other hand, has been found to be correlated with an increased prevalence of gonorrhea, tuberculosis, Streptococcus pneumoniae, Escherichia coli, and Salmonella infections. Lastly, blood type AB has been linked to an elevated incidence of smallpox, Escherichia coli, and Salmonella infections\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. Moreover, ABO antigens have been shown to have an impact on the synthesis of various glycoproteins within the circulatory system, specifically those derived from endothelial cells. Those glycoproteins, such as von Willebrand factor (VWF), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble thrombomodulin (sTM), serve as indicators for assessing vascular endothelial cell damage\u003csup\u003e\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. It is worth noting that the polymorphism of the ABO blood group can result in varying susceptibilities to pathogenic microorganisms, consequently leading to different degrees of infection in the host. ABO antigens existing on the surface of vascular endothelial cells (VECs) can exert an influence on the functionality of VECs. The susceptibility of pathogenic microorganism, as well as the functionality of VECs, can both play a role in determining the prognosis of septic patients.\u003c/p\u003e \u003cp\u003eIn recent times, several inquiries have been conducted regarding the correlation between ABO blood type and mortality among septic patients. A subset of septic shock patients with blood type O showed increased 90-day mortality but no influence on 28-day mortality in a Japan study on ABO blood types and mortality in septic patients\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. One possible explanation is that patients with blood type O tend to have plasma vWF levels that are 25\u0026ndash;30% lower than those with other blood types, thereby impairing sepsis-related coagulation and immunological responses\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. 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\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. 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. Nevertheless, a study involving critically ill patients with trauma and sepsis, has indicated that blood type A is associated with a higher prevalence of acute kidney injury (AKI) and acute respiratory distress syndrome (ARDS) in a subset of individuals of European ancestry\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Therefore, a single-center retrospective observation study was undertaken to examine the relationship between ABO blood types and the occurrence of organ dysfunction and mortality in septic patients, so as to provide a reference for the enhanced clinical management of septic patients with varying ABO blood types.\u003c/p\u003e"},{"header":"Material and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePatient and data\u003c/h2\u003e \u003cp\u003eThis was a retrospective observational study that included all patients admitted to the Department of intensive critical unit of the Chinese People's Liberation Army Strategic Support Forces Specialized Medical Center from 1 January 2015 to 31 December 2021. Inclusion criteria were as follows: 1. patients were elder than 16 years old. 2. Sepsis diagnosis criteria according to The Third International Consensus Definitions for Sepsis and Septic Shock(Sepsis 3.0): sepsis was classified as infection plus sequential organ failure (SOFA score\u0026thinsp;\u0026ge;\u0026thinsp;2)\u003csup\u003e13\u003c/sup\u003e. ΔSOFA is the difference in SOFA score before and after sepsis diagnosis. Exclusion criteria: 1. Patients were younger than 16 years. 2. The patient who admitted to the ICU more than one time during hospital admission was counted only once. 3. The patient and their family give up treatment. 4. Patients with blood type were absented.\u003c/p\u003e \u003cp\u003eThe following information was retrospectively collected from medical records: age, gender, blood type, major underlying disease, Acute Physiology and Chronic Health Status Scoring System II (APACHE II) score, Sequential (Sepsis- related) Organ Failure Assessment (SOFA) score, values of each SOFA score within 7 days after admission to ICU, source of infection, and 28-day mortality (patients discharged within 28 days were confirmed as survivors).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eDefinitions\u003c/h2\u003e \u003cp\u003eA newly \u0026ldquo;developed or exacerbated organ dysfunction\u0026rdquo; (d/eOD) was defined as previously research. Briefly, the newly \u0026ldquo;d/eOD\u0026rdquo; was defined as a net increase in SOFA score\u0026thinsp;\u0026ge;\u0026thinsp;2 of at least one organ within 7 days after admission in ICU over the baseline (SOFA score in the first 24h)\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. The worst SOFA was adopted after diagnosed sepsis from the second 24h until day 7. The primary outcome measures were the incidence of newly \u0026ldquo;d/eOD\u0026rdquo; and 28-day mortality.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe data was statistically analyzed using SPSS 19.0 statistical software. Continuous variables were presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (x\u0026thinsp;\u0026plusmn;\u0026thinsp;s); independent samples t-test was used to compare the differences between groups. Categorical variables were depicted as the number of groups (the number of percentages) and chi-squared test or Fisher\u0026rsquo;s exact test was used for comparison among groups. Multifactorial logistic regression and \u003cem\u003eCOX\u003c/em\u003e regression analyses were employed to assess the effects of different groups on the incidence of organ dysfunction and 28-day mortality. \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered a significant difference.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n\u003ch2\u003e1.The distribution of ABO blood types for patients with sepsis\u003c/h2\u003e\n\u003cp\u003eA cohort of 184 septic patients were admitted to our ICU during the period from 2015-01-01 to 2021-12-31. Among them, 14 patients lacked information regarding their blood type, and 4 patients had multiple admissions. Consequently, 166 septic patients were eligible for inclusion in this study, as determined the established exclusion criteria (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n\u003ch2\u003e2. Baseline characteristics and 28-day mortality in sepsis patients with newly d/eOD\u003c/h2\u003e\n\u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e, there was a significant association between the occurrence of newly d/eOD within 7 days after admission to ICU and blood type(P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). However no significant correlation was observed between this incidence and factors such as gender, age, APACHE II score and SOFA score within 24 hours of admission, comorbidity, or cause of infection. The data showed that septic patients with blood type AB exhibited the highest incidence of newly d/eOD within 7 days, with a rate of 62.50%. Conversely, patients with blood type B displayed the lowest incidence at 26.67%. Furthermore, patients with blood type O demonstrated a significantly elevated prevalence of hematologic and cardiovascular dysfunction compared to those with blood type B (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Similarly, septic patients with blood type AB exhibited a significantly higher occurrence of liver dysfunction in comparison to patients with blood type O and A (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). Interestingly, the study revealed that the 28-day mortality rate in septic patients with newly d/eOD within 7 days was slightly higher compared to those with non-newly d/eOD, although the observed difference did not reach statistical significance (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eBaseline characteristics in septic patients with and without newly d/eOD\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eClinical variables\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ed/eOD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003enon-d/eOD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.68\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMale n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e41(66.13)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e72(69.23)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFemale n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21(33.87)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e32(30.77)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e79.87\u0026thinsp;\u0026plusmn;\u0026thinsp;11.94\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e78.42\u0026thinsp;\u0026plusmn;\u0026thinsp;10.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.37\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAPACHE II score\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21.32\u0026thinsp;\u0026plusmn;\u0026thinsp;6.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21.83\u0026thinsp;\u0026plusmn;\u0026thinsp;6.53\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.69\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSOFA score\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7.97\u0026thinsp;\u0026plusmn;\u0026thinsp;3.22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e8.37\u0026thinsp;\u0026plusmn;\u0026thinsp;3.38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.41\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eComorbidities\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCoronary Artery Disease n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e20(32.26)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e37(35.58)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.66\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCardiac insufficiency n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(3.23)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1(0.96)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.29\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDiabetes n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18(29.03)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e39(37.50)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.27\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHypertension n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e29(46.77)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e62(59.62)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.11\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMalignancy n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7(11.29)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4(3.85)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.06\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCerebrovascular disease n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e13(20.97)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e22(21.15)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSource of infection\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRespiratory system n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e47(75.81)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e71(68.27)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.30\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAbdominal n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6(9.68)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12(11.54)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.71\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntravascular catheter n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(4.84)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5(4.81)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUriary n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(3.23)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5(4.81)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOthers n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(4.84)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e11(10.58)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.20\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eBlood type\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eO n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e22(35.48)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35(33.65)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eA n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14(22.58)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e19(18.27)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eB n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16(25.81)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e44(42.31)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAB n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10(16.13)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6(5.77)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e28-day mortality (%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e48.39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e40.38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.31\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations\u003c/strong\u003e:d/eOD, developed or exacerbated organ dysfunction; APACHE II score, Acute Physiology and Chronic Health Status Scoring System II score; SOFA score, Sequential (Sepsis- related) Organ Failure Assessment (SOFA) score.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n\u003ch2\u003e3. Baseline characteristics and outcomes in different ABO blood type in septic patients\u003c/h2\u003e\n\u003cp\u003eBecause the occurrence of newly d/eOD might be associated with ABO blood type, the patients were divided to four groups based on ABO blood type: 57 patients with blood type O (34.34%), 33 patients with blood type A (19.88%), 60 patients with blood type B (36.14%), and 16 patients with blood type AB (9.64%) (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e, Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). The distribution of ABO blood type observed in this study was found to be similar to that of the general Chinese population (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.bloodlook.com/world-abo.html\u003c/span\u003e\u003c/span\u003e). The baseline characteristics of patients with sepsis and outcome according to the ABO blood type were showed in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e. Significant variations were observed in age, SOFA score, complications of malignancy, and infection originating from the abdomen among the four groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), while other clinical characteristics exhibited similar distribution. The chi-squared test revealed that septic patients with blood type B exhibited significantly lower 28-day mortality (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and a lower incidence of new d/eOD within 7 days (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.05) compared to the other groups (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). The differences in outcomes between septic patients with blood type B and non-B were further analyzed.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eBaseline characteristics of septic patients with different ABO blood types\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eBlood Type\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eO\u003c/p\u003e\n\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;57)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eA\u003c/p\u003e\n\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;33)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eB\u003c/p\u003e\n\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAB\u003c/p\u003e\n\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;16)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eMale n(%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e42(73.68)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e21(63.64)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e40(66.67)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10(62.50)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.701\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e79.8\u0026thinsp;\u0026plusmn;\u0026thinsp;10.12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e81.49\u0026thinsp;\u0026plusmn;\u0026thinsp;9.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e80.40\u0026thinsp;\u0026plusmn;\u0026thinsp;10.84\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e81.78\u0026thinsp;\u0026plusmn;\u0026thinsp;9.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAPACHE II score\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21.61\u0026thinsp;\u0026plusmn;\u0026thinsp;6.39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22.15\u0026thinsp;\u0026plusmn;\u0026thinsp;7.63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21.63\u0026thinsp;\u0026plusmn;\u0026thinsp;5.70\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25.8\u0026thinsp;\u0026plusmn;\u0026thinsp;4.72\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.15\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSOFA score\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7.95\u0026thinsp;\u0026plusmn;\u0026thinsp;3.46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7.73\u0026thinsp;\u0026plusmn;\u0026thinsp;2.76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e8.31\u0026thinsp;\u0026plusmn;\u0026thinsp;3.36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.24\u0026thinsp;\u0026plusmn;\u0026thinsp;3.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eComorbidities\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCoronary Artery Disease n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14(24.56)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11(33.33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e26(43.33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6(37.50)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.13\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCardiac insufficiency n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1(1.75)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0(0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(3.33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0(0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.64\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDiabetes n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17(29.82)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12(36.36)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e24(40.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4(25.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.48\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHypertension n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e31(54.39)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18(54.54)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e34(56.67)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8(50.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.96\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMalignancy n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(5.26)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6(18.18)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(3.33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0(0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.02\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCerebrovascular disease n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e13(22.81)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9(27.27)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10(16.67)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3(18.75)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.61\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSource of infection\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRespiratory system n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e43(75.44)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20(60.61)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e44(73.33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11(68.75)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.30\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAbdominal n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4(7.02)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8(24.24)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(5.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3(18.75)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.01\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntravascular catheter n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(5.26)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2(6.06)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(5.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0(0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.81\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUriary n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(3.51)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1(3.03)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(5.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1(6.25)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.74\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOthers n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5(8.77)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2(6.06)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7(11.67)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2(12.50)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.80\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e28-day mortality (%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e52.63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51.51\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e26.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e56.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ed/eOD (%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e38.60\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e26.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e62.50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n\u003ch2\u003e4. Baseline characteristics and outcomes between blood type B and non-B in septic patients\u003c/h2\u003e\n\u003cp\u003eThe baseline characteristics of septic patients with blood type B were found to be similar distributed compared to those with non-B blood type. Interestingly, compared with those with non-B blood type, septic patients with blood type B exhibited a lower 28-day mortality rate and a lower incidence of new d/eOD within 7 days (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). The data also revealed that septic patients with non-B blood type had a higher total \u0026Delta;SOFA score within 7 days after admission to ICU. However, there was no statistically significant difference observed in the occurrence of single organ dysfunction in the respiratory, hematological, hepatic, cardiovascular, neurological, and renal systems between blood type B patients and non-B blood type patients (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eBaseline characteristics of septic patients with blood type B and those with non- B blood type\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eBlood type\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eB\u003c/p\u003e\n\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eNon-B\u003c/p\u003e\n\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;106)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eMale n(%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e40(66.67)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e73(68.87)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.77\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e80.40\u0026thinsp;\u0026plusmn;\u0026thinsp;10.84\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e79.16\u0026thinsp;\u0026plusmn;\u0026thinsp;10.85\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.76\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAPACHE II score\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21.63\u0026thinsp;\u0026plusmn;\u0026thinsp;5.70\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e22.41\u0026thinsp;\u0026plusmn;\u0026thinsp;6.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.45\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSOFA score\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e8.31\u0026thinsp;\u0026plusmn;\u0026thinsp;3.36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e8.11\u0026thinsp;\u0026plusmn;\u0026thinsp;3.30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.59\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eComorbidities\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCoronary artery disease n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e26(43.33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e31(29.25)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.07\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCardiac insufficiency n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(3.33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1(0.94)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.27\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDiabetes mellitus n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e24(40.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e33(31.13)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.25\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHypertension n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e34(56.67)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e57(53.77)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.72\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMalignancy n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(3.33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9(8.49)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.20\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCerebrovascular disease n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10(16.67)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e25(23.58)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.29\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSource of infection\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRespiratory system n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e44(73.33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e74(69.81)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.63\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAbdominal n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(5.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15(14.15)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.07\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntravascular catheterization n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(5.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5(4.72)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.94\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUriary n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(5.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4(3.77)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.71\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOthers n(%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7(11.67)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7(6.60)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.26\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e28-day mortality (%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e26.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e52.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ed/eOD (%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e26.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e43.40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.03\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n\u003ch2\u003e5. Association between blood type B and 28-day mortality in septic patients\u003c/h2\u003e\n\u003cp\u003eAge, gender, APACHE II score, and SOFA score are known to as common factors that influence disease morbidity and mortality. In our study, we included those variables in the COX regression analysis and observed that blood type B and SOFA score were significantly associated with 28-day mortality in septic patients (HR 0.42; 95% CI 0.24\u0026ndash;0.74; P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). However, we found that 28-day mortality was not associated with APACHE II score, age and gender (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e6. Impact of blood type B on the risk potential of newly d/eOD in septic patients\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe finding from our analysis of data in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e and Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e indicate a significant association between ABO blood type and the occurrence of newly d/eOD. In order to further investigate the potential of blood type B in reducing the risk of new D/eOD, we conducted a multivariate logistic regression analysis. This analysis revealed that blood type B was independently linked to a lower frequency of d/eOD (OR 0.48; 95% CI 0.24\u0026ndash;0.96; P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). However, Variables such as SOFA score, APACHE II score, gender and age did not show a significant correlation with newly d/eOD within 7 days after admission to ICU (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003e This study, conducted retrospectively at a single center, revealed that septic patients with blood type B, admitted to the intensive care unit, exhibited a notably lower 28-day mortality compared to those with non-B blood type. Additionally, the study identified the SOFA score as a significant risk factor influencing 28-day mortality of septic patients. In comparison to individuals with non-B blood type, septic patients with blood type B exhibited a notable reduction in the incidence of newly d/eOD within 7 days after admission in ICU, although there was no statistically significant difference observed in the rate of decline of individual organ dysfunction, encompassing respiratory, hematologic, hepatic, cardiovascular, neurologic, and kidney systems, between septic patients with blood type B and those with blood type non-B. The observed higher survival rate of individuals with blood type B in our study aligns consistently with the findings of a previously conducted large multicenter study in Denmark\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. In addition, based on our current understanding, this study represents the initial investigation to document correlation between ABO blood type and incidence of organ dysfunction morbidity in septic patients. Despite the unalterable nature of patients\u0026rsquo; ABO blood type as an inherent genetic characteristic, timely and accurate identification of high-risk patients can substantially enhance the morbidity and mortality outcomes associated with organ dysfunction in sepsis.\u003c/p\u003e \u003cp\u003eThe ABO blood type exhibits a diverse range of characteristics due to variations in antigenic surface monosaccharides. The impact of ABO blood type on organ function is associated with endothelial cell dysfunction, microcirculatory coagulation, and inflammation\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. ABO blood type antigens play a crucial role in determining the levels of soluble ICAM-1, selectin, vWF, and thrombomodulin in the plasma, which in turn can influence coagulation, cardiovascular, respiratory, and renal function\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. Patients with blood type O are at an increased risk of bleeding due to a notable decrease in their plasma vWF levels, which are approximately 25\u0026ndash;30% lower compared to individuals with non-O blood types. Conversely individuals with non-O blood types exhibited higher plasma concentrations of coagulation factors, including vWF and factor VIII, thereby resulting in an elevated susceptibility to ischemic heart disease and thromboembolic disease when compared to those blood type O\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. Patients with serious trauma and sepsis who are blood type A have a substantially greater risk of AKI and ARDS than other blood types in European populations. This increasing risk can be attributed to the strong association between blood type A and sTM and vWF\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. vWF is a large polysaccharide protein primarily synthesized by endothelial cells and released into the bloodstream through Weibel-Palade vesicles, along with other proteins. By attaching to factor VIII, vWF facilitates platelet polymerization and subsequent adhesion to damaged endothelial cells, thereby promoting coagulation. Thrombomodulin, a glycoprotein present on the endothelial cell surface, functions as a receptor for thrombin, thereby enhancing the activation of protein C induced by thrombin and consequently exhibiting an anticoagulant impact. In critically ill patient, thrombomodulin undergoes cleavage and subsequent release from the endothelial cell membrane into the plasma. The influence 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\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. 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. In a study examining the correlation between ABO blood types and AKI in critically ill patients with trauma or sepsis, the incidence of coagulation dysfunction was found to be substantially reduced in patients with blood type B compared to other blood types\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Our investigation also revealed that septic patients with blood type B demonstrated a decreased incidence of organ failure in the respiratory, hematologic, cardiovascular and nervous systems in comparison to those with non-B blood types, although this disparity did not reach statistical significance. Previous research confirms that blood type A is independently associated with AKI risk in patients with severe sepsis of European descent, which different from the results of this study\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. However, the incidence of ARDS in individuals with severe sepsis and major trauma, encompassing both white and black population, demonstrated a decreased likelihood in patients with blood type B when compared to other blood types, aligning with our results\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn our study, we observed a notable decrease in 28-day mortality among septic patients with blood type B compared to those with non-B blood type. This finding may be attributed to a significantly lower incidence of new d/eOD within 7 days in patients with blood type B. Consequently, it suggests a potential association between the genetic information of ABO blood type and the incidence of organ dysfunction and mortality in septic patients. A previous study reported that there was no association between blood types and 30-day mortality in 752 septic patients. However, it was found that individuals with blood type B had a lower mortality compared to those with other blood types\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Conversely, a comprehensive retrospective study conducted in Japan revealed that septic patients with blood type B exhibited reduced both 28-day and 90-day mortality when compared to individuals with other blood types\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. Additionally, a multicenter observational study conducted in Spain reported that patients with blood type B had lower ICU mortality in relation to other blood types in the context of severe hypoxic respiratory failure\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. A study conducted in Swedish examined the relationship between ABO blood type and morbidity and mortality in critically ill patients. The findings revealed that patients with blood type B exhibited slightly lower 28-day and 90-day mortality compared to patients with other blood types\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. 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 types \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. 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. Our research particularly examined mortality among septic patients with blood type B and those with non-B blood types. The finding revealed that patients with blood type B exhibited a reduced occurrence of newly d/eOD and 28-day mortality, indicating that blood type B severs as a protective factor against sepsis.\u003c/p\u003e \u003cp\u003eOur study suffers from some flaws. Firstly, in order to validate the findings, it is necessary to include a large sample size as our analysis was based on a retrospective analysis conducted at single center. Furthermore, due to the retrospective nature, there were some data defects that could potentially impact the outcomes. Although the amount of missing data was minimal, with only 14 patients lacking blood type information, it is important to acknowledge this limitation. Additionally, it is worth noting that the severity of disease in our study was notably high, with 66.27% of patients presenting with septic shock. This observation may be attributed to a potential lack of comprehensive understanding of sepsis among medical practitioner, leading to delays in ICU admission. All of the aforementioned factors exerted an impact on the prognosis of patients with sepsis. However, we collected a relatively complete data about 28-day survival and the function of each organ in septic patients, and it was a relatively accurate analysis about the relationship between 28-day mortality and newly d/eOD and ABO blood types in intensive care unit.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThere was a genetic difference in morbidity and mortality among septic patients with ABO blood types in this single-center retrospective observational research. Compared to those with non-B blood type, septic patients with blood type B are associated with a lower incidence of newly d/eOD within 7 days and 28-day mortality. It means that blood type B is a protective factor for sepsis.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYi Lingxian designed the study protocol and writing the manuscript. Zheng HZ and Jin HY were responsible for data collection. Zhang Q were responsible for statistical analysis. Song HJ helped in drafting the manuscript. All authors reviewed and approved the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis project was funded in part by grants from the Young Science Foundation of National Natural Science Foundation of China (Grant no.82202404)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and meterials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data used for this publication are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research project is a retrospective observation study that adheres to the pertinent national laws and regulations. Our committee medical ethics considered that it is no necessity to procure informed consent and ethical approval.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGreen C. The ABO, Lewis and related blood group antigens; a review of structure and biosynthesis. \u003cem\u003eFEMS Microbiol Immunol\u003c/em\u003e. 1989;1:321-30.\u003c/li\u003e\n\u003cli\u003eCartron JP and Colin Y. Structural and functional diversity of blood group antigens. \u003cem\u003eTransfus Clin Biol\u003c/em\u003e. 2001;8:163-99.\u003c/li\u003e\n\u003cli\u003eAbegaz SB. Human ABO Blood Groups and Their Associations with Different Diseases. \u003cem\u003eBiomed Res Int\u003c/em\u003e. 2021;2021:6629060.\u003c/li\u003e\n\u003cli\u003eKiechl S, Pare G, Barbalic M, Qi L, Dupuis J, Dehghan A, et al. Association of variation at the ABO locus with circulating levels of soluble intercellular adhesion molecule-1, soluble P-selectin, and soluble E-selectin: a meta-analysis. \u003cem\u003eCirc Cardiovasc Genet\u003c/em\u003e. 2011;4:681-6.\u003c/li\u003e\n\u003cli\u003eBarbalic M, Dupuis J, Dehghan A, Bis JC, Hoogeveen RC, Schnabel RB, et al. Large-scale genomic studies reveal central role of ABO in sP-selectin and sICAM-1 levels. \u003cem\u003eHum Mol Genet\u003c/em\u003e. 2010;19:1863-72.\u003c/li\u003e\n\u003cli\u003eMorelli VM, de Visser MC, van Tilburg NH, Vos HL, Eikenboom JC, Rosendaal FR, et al. ABO blood group genotypes, plasma von Willebrand factor levels and loading of von Willebrand factor with A and B antigens. \u003cem\u003eThromb Haemost\u003c/em\u003e. 2007;97:534-41.\u003c/li\u003e\n\u003cli\u003eFranchini M, Capra F, Targher G, Montagnana M and Lippi G. Relationship between ABO blood group and von Willebrand factor levels: from biology to clinical implications. \u003cem\u003eThromb J\u003c/em\u003e. 2007;5:14.\u003c/li\u003e\n\u003cli\u003eHasegawa D, Nishida K, Kawaji T, Hara Y, Shimomura Y, Moriyama K, et al. Impact of Blood Type O on Mortality of Sepsis Patients: A Multicenter Retrospective Observational Study. \u003cem\u003eDiagnostics (Basel)\u003c/em\u003e. 2020;10.\u003c/li\u003e\n\u003cli\u003eDentali F, Sironi AP, Ageno W, Bonfanti C, Crestani S, Frattini F, et al. Relationship between ABO blood group and hemorrhage: a systematic literature review and meta-analysis. \u003cem\u003eSemin Thromb Hemost\u003c/em\u003e. 2013;39:72-82.\u003c/li\u003e\n\u003cli\u003eItenov TS, Sessler DI, Khanna AK, Ostrowski SR, Johansson PI, Erikstrup C, et al. ABO blood types and sepsis mortality. \u003cem\u003eAnn Intensive Care\u003c/em\u003e. 2021;11:61.\u003c/li\u003e\n\u003cli\u003eReilly JP, Meyer NJ, Shashaty MGS, Feng R, Lanken PN, Gallop R, et al. ABO blood type A is associated with increased risk of ARDS in whites following both major trauma and severe sepsis. \u003cem\u003eChest\u003c/em\u003e. 2014;145:753-761.\u003c/li\u003e\n\u003cli\u003eReilly JP, Anderson BJ, Mangalmurti NS, Nguyen TD, Holena DN, Wu Q, et al. The ABO Histo-Blood Group and AKI in Critically Ill Patients with Trauma or Sepsis. \u003cem\u003eClin J Am Soc Nephrol\u003c/em\u003e. 2015;10:1911-20.\u003c/li\u003e\n\u003cli\u003eSinger M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). \u003cem\u003eJAMA\u003c/em\u003e. 2016;315:801-10.\u003c/li\u003e\n\u003cli\u003eWang T, Yi L, Zhang H, Wang T, Xi J, Zeng L, et al. Risk Potential for Organ Dysfunction Associated With Sodium Bicarbonate Therapy in Critically Ill Patients With Hemodynamic Worsening. \u003cem\u003eFront Med (Lausanne)\u003c/em\u003e. 2021;8:665907.\u003c/li\u003e\n\u003cli\u003ePare G, Chasman DI, Kellogg M, Zee RY, Rifai N, Badola S, et al. Novel association of ABO histo-blood group antigen with soluble ICAM-1: results of a genome-wide association study of 6,578 women. \u003cem\u003ePLoS Genet\u003c/em\u003e. 2008;4:e1000118.\u003c/li\u003e\n\u003cli\u003eReilly JP, Meyer NJ, Shashaty MG, Anderson BJ, Ittner C, Dunn TG, et al. The ABO histo-blood group, endothelial activation, and acute respiratory distress syndrome risk in critical illness. \u003cem\u003eJ Clin Invest\u003c/em\u003e. 2021;131.\u003c/li\u003e\n\u003cli\u003eRezoagli E, Gatti S, Villa S, Villa G, Muttini S, Rossi F, et al. ABO blood types and major outcomes in patients with acute hypoxaemic respiratory failure: A multicenter retrospective cohort study. \u003cem\u003ePLoS One\u003c/em\u003e. 2018;13:e0206403.\u003c/li\u003e\n\u003cli\u003eKander T, Bjurstrom MF, Frigyesi A, Joud M and Nilsson CU. ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients. \u003cem\u003eBMC Anesthesiol\u003c/em\u003e. 2022;22:91.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sepsis, SOFA score, Organ failure, Blood type, Mortality, Morbidity","lastPublishedDoi":"10.21203/rs.3.rs-3917942/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3917942/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eSepsis 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.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA 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%, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.03) and 28-day mortality (52.83% vs 26.67%, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.00). Multivariate \u003cem\u003eCox\u003c/em\u003e regression analysis showed that both blood type B [HR 0.42, 95% CI (0.24\u0026ndash;0.74), \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01] and SOFA score [HR 1.14, 95% CI (1.05\u0026ndash;1.24), \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;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\u0026ndash;0.96), \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.04].\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eBlood 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.\u003c/p\u003e","manuscriptTitle":"Impact of ABO blood type on morbidity of organ dysfunction and mortality in septic patients: a single center retrospective observational study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-20 18:14:50","doi":"10.21203/rs.3.rs-3917942/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1ff3e3c0-769c-4aab-94c2-f2cb2ed25cae","owner":[],"postedDate":"February 20th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-05-21T08:04:23+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-20 18:14:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3917942","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3917942","identity":"rs-3917942","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}