Network-Based Modeling of Sepsis: Quantification and Evaluation of Simultaneity of Organ Dysfunctions
Network-Based Modeling of Sepsis: Quantification and Evaluation of Simultaneity of Organ Dysfunctions
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基于网络的脓毒症建模：器官功能障碍同时性的量化和评估
DOI：
10.1145/3307339.3342160
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Arnold, Ryan
中科院分区：
文献类型：
--
作者：
Jazayeri, Ali;Capan, Muge;Yang, Christopher;Khoshnevisan, Farzaneh;Chi, Min;Arnold, Ryan
研究表明，在脓毒症的早期阶段进行适当的治疗管理对于防止进一步恶化和不可逆的器官损伤至关重要。虽然以前的研究认为细胞和生理反应作为脓毒症相关预测模型的组成部分，但反应之间的时间联系尚未得到广泛研究。本研究的目的是研究脓毒症患者的7种器官系统功能障碍的16个临床变量所代表的细胞和生理反应的同时变化，以预测院内死亡率。器官功能障碍由以下组成的无向加权网络模型表示：i）节点（即，16个临床变量和三种生物标志物，包括降钙素原、C反应蛋白和沉降率），ii）边缘（即，表示同时功能障碍的节点对之间的连接），以及iii）表示两个功能障碍的共同出现的持续性的权重。从2013年7月1日至2015年12月31日期间入住研究医院的13，367例成人患者（对应于17，953次访视）中收集数据。根据代表脓毒症进展的临床标准对研究人群进行分类，以确定不同的亚群。研究结果量化了定义两种功能障碍的最佳窗口，对应于不同亚群的网络属性，亚群之间同时功能障碍的歧视模式和住院死亡率预测。结果表明，同时功能障碍的持续性水平是亚人群特异性的。从这项研究中获得的关于同时发生的器官功能障碍的持续性和组合的最佳阈值的见解可以为个性化住院死亡率预测的政策提供信息。
It is shown that appropriate therapeutic management at early stages of sepsis are crucial for preventing further deterioration and irreversible organ damage. Although previous studies considered the cellular and physiological responses as the components of sepsis-related predictive models, temporal connections among the responses have not been widely studied. The objective of this study is to investigate simultaneous changes in cellular and physiological responses represented by 16 clinical variables contributing to seven organ system dysfunctions in patients with sepsis to predict in-hospital mortality. Organ dysfunctions were represented by undirected weighted network models composed of: i) nodes (i.e., 16 clinical variables and three biomarkers including procalcitonin, C-reactive protein, and sedimentation rate), ii) edges (i.e., connection between pair of nodes representing simultaneous dysfunctions), and iii) weights representing the persistence of the co-occurrence of two dysfunctions. Data was collected from 13,367 adult patients (corresponding to 17,953 visits) admitted to the study hospital from July 1, 2013, to December 31, 2015. The study population were categorized based on clinical criteria representing sepsis progression to identify different subpopulations. The findings quantify the optimal window for defining the simultaneity of two dysfunctions, the network properties corresponding to different subpopulations, the discriminatory patterns of simultaneous dysfunctions among subpopulations and in-hospital mortality prediction. The results show that the level of persistence of simultaneous dysfunctions are subpopulation-specific. Insights from this study regarding optimal thresholds of the persistence and combination of simultaneous organ dysfunctions can inform policies to personalize the in-hospital mortality prediction.
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使用 Apache II 评分系统评估脓毒症患者的几种细胞因子和蛋白 C 水平。
影响因子：
3
作者：
E. Kartal;Emine Karkaç;Z. Gülbaş;S. N. Alpat;N. Erben;E. Çolak
通讯作者：
E. Çolak
验证修改后的多系统器官衰竭评分作为艾滋病相关卡氏肺孢子虫肺炎和呼吸衰竭患者死亡率的预测因子。
影响因子：
9.6
作者：
D. Forrest;O. Djurdjev;C. Zala;J. Singer;L. Lawson;J. Russell;J. Montaner
通讯作者：
J. Montaner
影响因子：
3.1
作者：
Lee, S-W;Hong, Y-S;Baek, K-J
通讯作者：
Baek, K-J
DOI：
10.1186/cc13070
发表时间：
2013-10-20
期刊：
Critical care (London, England)
影响因子：
--
作者：
Liu B;Chen YX;Yin Q;Zhao YZ;Li CS
通讯作者：
Li CS
影响因子：
4.4
作者：
Howell, Michael D.;Donnino, Michael W.;Shapiro, Nathan I.
通讯作者：
Shapiro, Nathan I.