Article ; Online: Identification of Clinically Significant Cytokine Signature Clusters in Patients With Septic Shock.
2023 Volume 51, Issue 12, Page(s) e253–e263
Abstract: Objectives: To identify cytokine signature clusters in patients with septic shock.: Design: Prospective observational cohort study.: Setting: Single academic center in the United States.: Patients: Adult (≥ 18 yr old) patients admitted to the ... ...
| Abstract | Objectives: To identify cytokine signature clusters in patients with septic shock. Design: Prospective observational cohort study. Setting: Single academic center in the United States. Patients: Adult (≥ 18 yr old) patients admitted to the medical ICU with septic shock requiring vasoactive medication support. Interventions: None. Measurements and main results: One hundred fourteen patients with septic shock completed cytokine measurement at time of enrollment (t 1 ) and 24 hours later (t 2 ). Unsupervised random forest analysis of the change in cytokines over time, defined as delta (t 2 -t 1 ), identified three clusters with distinct cytokine profiles. Patients in cluster 1 had the lowest initial levels of circulating cytokines that decreased over time. Patients in cluster 2 and cluster 3 had higher initial levels that decreased over time in cluster 2 and increased in cluster 3. Patients in clusters 2 and 3 had higher mortality compared with cluster 1 (clusters 1-3: 11% vs 31%; odds ratio [OR], 3.56 [1.10-14.23] vs 54% OR, 9.23 [2.89-37.22]). Cluster 3 was independently associated with in-hospital mortality (hazard ratio, 5.24; p = 0.005) in multivariable analysis. There were no significant differences in initial clinical severity scoring or steroid use between the clusters. Analysis of either t 1 or t 2 cytokine measurements alone or in combination did not reveal clusters with clear clinical significance. Conclusions: Longitudinal measurement of cytokine profiles at initiation of vasoactive medications and 24 hours later revealed three distinct cytokine signature clusters that correlated with clinical outcomes. |
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| MeSH term(s) | Adult ; Humans ; United States/epidemiology ; Shock, Septic ; Prospective Studies ; Cytokines | |||||
| Chemical Substances | Cytokines | |||||
| Language | English | |||||
| Publishing date | 2023-09-05 | |||||
| Publishing country | United States | |||||
| Document type | Observational Study ; Journal Article ; Research Support, N.I.H., Extramural | |||||
| ZDB-ID | 197890-1 | |||||
| ISSN | 1530-0293 ; 0090-3493 | |||||
| ISSN (online) | 1530-0293 | |||||
| ISSN | 0090-3493 | |||||
| DOI | 10.1097/CCM.0000000000006032 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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