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Six subphenotypes in septic shock: Latent class analysis of the PROWESS Shock study.
Gårdlund, Bengt; Dmitrieva, Natalia O; Pieper, Carl F; Finfer, Simon; Marshall, John C; Taylor Thompson, B.
Afiliación
  • Gårdlund B; Department of Infectious Diseases, Karolinska Hospital, S-14186 Stockholm, Sweden. Electronic address: bengt.gardlund@gmail.com.
  • Dmitrieva NO; Center for the study of Aging and Human Development, Department of Biostatistics and Bioinformatics, Northern Arizona University, PO Box 15106, Flagstaff, AZ 86011, United States. Electronic address: Natalia.Dmitrieva@nau.edu.
  • Pieper CF; Center on Aging, Dept. of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, United States. Electronic address: carl.pieper@duke.edu.
  • Finfer S; The George Institute for Global Health, University of New South Wales, Level 5, 1 King Street, Newtown, NSW 2042, Australia. Electronic address: sfinfer@georgeinstitute.org.au.
  • Marshall JC; University of Toronto, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada. Electronic address: marshallj@smh.ca.
  • Taylor Thompson B; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02140, United States. Electronic address: TTHOMPSON1@mgh.harvard.edu.
J Crit Care ; 47: 70-79, 2018 10.
Article en En | MEDLINE | ID: mdl-29933169
PURPOSE: Septic shock is a highly heterogeneous condition which is part of the challenge in its diagnosis and treatment. In this study we aim to identify clinically relevant subphenotypes of septic shock using a novel statistic al approach. METHODS: Baseline patient data from a large global clinical trial of septic shock (n = 1696) was analysed using latent class analysis (LCA). This approach allowed investigators to identify subgroups in a heterogeneous population by estimating a categorical latent variable that detects relatively homogeneous subgroups within a complex phenomenon. RESULTS: LCA identified six different, clinically meaningful subphenotypes of septic shock each with a typical profile: (1) "Uncomplicated Septic Shock, (2) "Pneumonia with adult respiratory distress syndrome (ARDS)", (3) "Postoperative Abdominal", (4) "Severe Septic Shock", (5): "Pneumonia with ARDS and multiple organ dysfunction syndrome (MODS)", (6) "Late Septic Shock". The 6-class solution showed high entropy approaching 1 (i.e., 0.92), indicating there was excellent separation between estimated classes. CONCLUSIONS: LCA appears to be an applicable statistical tool in analysing a heterogenous clinical cohort of septic shock. The results may lead to a better understanding of septic shock complexity and form a basis for considering targeted therapies and selecting patients for future clinical trials.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Síndrome de Dificultad Respiratoria / Choque Séptico / Análisis de Clases Latentes / Insuficiencia Multiorgánica Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Síndrome de Dificultad Respiratoria / Choque Séptico / Análisis de Clases Latentes / Insuficiencia Multiorgánica Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos