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Prediction of Mortality in Hemodialysis Patients Using Moving Multivariate Distance.
Liu, Mingxin; Legault, Véronique; Fülöp, Tamàs; Côté, Anne-Marie; Gravel, Dominique; Blanchet, F Guillaume; Leung, Diana L; Lee, Sylvia Juhong; Nakazato, Yuichi; Cohen, Alan A.
Afiliación
  • Liu M; PRIMUS Research Group, Department of Family Medicine, University of Sherbrooke, Sherbrooke, QC, Canada.
  • Legault V; PRIMUS Research Group, Department of Family Medicine, University of Sherbrooke, Sherbrooke, QC, Canada.
  • Fülöp T; Research Center on Aging, Sherbrooke, QC, Canada.
  • Côté AM; Department of Medicine, Geriatric Division, University of Sherbrooke, Sherbrooke, QC, Canada.
  • Gravel D; Department of Medicine, Nephrology Division, University of Sherbrooke, Sherbrooke, QC, Canada.
  • Blanchet FG; Research Center of Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
  • Leung DL; Département de Biologie, Université de Sherbrooke, Sherbrooke, QC, Canada.
  • Lee SJ; Research Center on Aging, Sherbrooke, QC, Canada.
  • Nakazato Y; Département de Biologie, Université de Sherbrooke, Sherbrooke, QC, Canada.
  • Cohen AA; Département de Mathématique, Université de Sherbrooke, Sherbrooke, QC, Canada.
Front Physiol ; 12: 612494, 2021.
Article en En | MEDLINE | ID: mdl-33776784
There is an increasingly widespread use of biomarkers in network physiology to evaluate an organism's physiological state. A recent study showed that albumin variability increases before death in chronic hemodialysis patients. We hypothesized that a multivariate statistical approach would better allow us to capture signals of impending physiological collapse/death. We proposed a Moving Multivariate Distance (MMD), based on the Mahalanobis distance, to quantify the variability of the multivariate biomarker profile as a whole from one visit to the next. Biomarker profiles from a visit were used as the reference to calculate MMD at the subsequent visit. We selected 16 biomarkers (of which 11 are measured every 2 weeks) from blood samples of 763 chronic kidney disease patients hemodialyzed at the CHUS hospital in Quebec, who visited the hospital regularly (∼every 2 weeks) to perform routine blood tests. MMD tended to increase markedly preceding death, indicating an increasing intraindividual multivariate variability presaging a critical transition. In survival analysis, the hazard ratio between the 97.5th percentile and the 2.5th percentile of MMD reached as high as 21.1 [95% CI: 14.3, 31.2], showing that higher variability indicates substantially higher mortality risk. Multivariate approaches to early warning signs of critical transitions hold substantial clinical promise to identify early signs of critical transitions, such as risk of death in hemodialysis patients; future work should also explore whether the MMD approach works in other complex systems (i.e., ecosystems, economies), and should compare it to other multivariate approaches to quantify system variability.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Front Physiol Año: 2021 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Front Physiol Año: 2021 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Suiza