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Multi-analytical Approaches Informing the Risk of Sepsis

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Biomedical Engineering Systems and Technologies (BIOSTEC 2009)

Abstract

Sepsis is a significant cause of mortality and morbidity and is often associated with increased hospital resource utilization, prolonged intensive care unit (ICU) and hospital stay. The economic burden associated with sepsis is huge. With advances in medicine, there are now aggressive goal oriented treatments that can be used to help these patients. If we were able to predict which patients may be at risk for sepsis we could start treatment early and potentially reduce the risk of mortality and morbidity. Analytic methods currently used in clinical research to determine the risk of a patient developing sepsis may be further enhanced by using multi-modal analytic methods that together could be used to provide greater precision. Researchers commonly use univariate and multivariate regressions to develop predictive models. We hypothesized that such models could be enhanced by using multiple analytic methods that together could be used to provide greater insight. In this paper, we analyze data about patients with and without sepsis using a decision tree approach and a cluster analysis approach. A comparison with a regression approach shows strong similarity among variables identified, though not an exact match. We compare the variables identified by the different approaches and draw conclusions about the respective predictive capabilities,while considering their clinical significance.

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References

  1. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Critical Care Medicine 20, 864–874 (1992)

    Google Scholar 

  2. Alberti, C., Brun-Buisson, C., Burchardi, H., Martin, C., Goodman, S., Artigas, A., Sicignano, A., Palazzo, M., Moreno, R., Boulme, R., Lepage, E., Le Gall, R.: Epidemiology of sepsis and infection in ICU patients from an international multicentre cohort study. Intensive Care Med. 28, 108–121 (2002)

    Article  Google Scholar 

  3. Angus, D.C., Linde-Zwirble, W.T., Lidicker, J., Clermont, G., Carcillo, J., Pinsky, M.R.: Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Critical Care Medicine 29, 1303–1310 (2002)

    Article  Google Scholar 

  4. Bernard, G.R., Vincent, J.L., Laterre, P.F., LaRosa, S.P., Dhainaut, J.F., Lopez-Rodriguez, A., Steingrub, J.S., Garber, G.E., Helterbrand, J.D., Ely, E.W., Fisher Jr., C.J.: Efficacy and safety of recombinant human activated protein C for severe sepsis. New England Journal of Medicine 344, 699–709 (2001)

    Article  Google Scholar 

  5. Brun-Buisson, C., Doyon, F., Carlet, J., Dellamonica, P., Gouin, F., Lepoutre, A., Mercier, J.C., Offenstadt, G., Regnier, B.: Incidence, risk factors, and outcome of severe sepsis and septic shock in adults: A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA 274, 968–974 (1995)

    Article  Google Scholar 

  6. Dellinger, R.P., Levy, M.M., Carlet, J.M., Bion, J., Parker, M.M., Jaeschke, R., Reinhart, K., Angus, D.C., Brun-Buisson, C., Beale, R., Calandra, T., Dhainaut, J.F., Gerlach, H., Harvey, M., Marini, J.J., Marshall, J., Ranieri, M., Ramsay, G., Sevransky, J., Thompson, B.T., Townsend, S., Vender, J.S., Zimmerman, J.L., Vincent, J.L.: Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock. Critical Care Medicine 36, 296–327 (2008)

    Google Scholar 

  7. Knaus, W.A., Draper, E.A., Wagner, D.P., Zimmerman, J.E.: APACHE II: a severity of disease classification system. Critical Care Medicine 13, 818–829 (1985)

    Article  Google Scholar 

  8. Knaus, W.A., Wagner, D.P., Draper, E.A., Zimmerman, J.E., Bergner, M., Bastos, P.G., Sirio, C.A., Murphy, D.J., Lotring, T., Damiano, A.: The APACHE III prognostic system: Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 100, 1619–1636 (1991)

    Article  Google Scholar 

  9. Letarte, J., Longo, C.J., Pelletier, J., Nabonne, B., Fisher, H.N.: Patient characteristics and costs of severe sepsis and septic shock in Quebec. Journal of Critical Care 17, 39–49 (2002)

    Article  Google Scholar 

  10. Levy, M.M., Fink, M.P., Marshall, J.C., Abraham, E., Angus, D., Cook, D., Cohen, J., Opal, S.M., Vincent, J.L., Ramsay, G.: SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Critical Care Medicine 31, 1250–1256 (2003)

    Google Scholar 

  11. Martin, C., Priestap, F., Fisher, H., Fowler, R.A., Heyland, D.K., Keenan, S.P., Longo, C.J., Morrison, T., Bentley, D., Antman, N.: A prospective, observational registry of patients with severe sepsis: The Canadian Sepsis Treatment And Response (STAR) Registry. Critical Care Medicine (in press)

    Google Scholar 

  12. Minneci, P.C., Deans, K.J., Banks, S.M., Eichacker, P.Q., Natanson, C.: Meta-analysis: the effect of steroids on survival and shock during sepsis depends on the dose. Ann. Intern. Med. 141, 47–56 (2004)

    Google Scholar 

  13. Pittet, D., Rangel-Frausto, S., Li, N., Tarara, D., Costigan, M., Rempe, L., Jebson, P., Wenzel, R.P.: Systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock: Incidence, morbidities and outcomes in surgical ICU patients. Intensive Care Medicine 21, 302–309 (1995)

    Google Scholar 

  14. Rivers, E., Nguyen, B., Havstad, S., Ressler, J., Muzzin, A., Knoblich, B., Peterson, E., Tomlanovich, M.: Early goal-directed therapy in the treatment of severe sepsis and septic shock. New England Journal of Med. 345, 1368–1377 (2001)

    Google Scholar 

  15. Salvo, I., de, C.W., Musicco, M., Langer, M., Piadena, R., Wolfler, A., Montani, C., Magni, E.: The Italian SEPSIS study: Preliminary results on the incidence and evolution of SIRS, sepsis, severe sepsis and septic shock. Intensive Care Medicine 21(suppl. 2), S244–S249 (1995)

    Google Scholar 

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Gwadry-Sridhar, F., Lewden, B., Mequanint, S., Bauer, M. (2010). Multi-analytical Approaches Informing the Risk of Sepsis. In: Fred, A., Filipe, J., Gamboa, H. (eds) Biomedical Engineering Systems and Technologies. BIOSTEC 2009. Communications in Computer and Information Science, vol 52. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11721-3_31

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  • DOI: https://doi.org/10.1007/978-3-642-11721-3_31

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-11720-6

  • Online ISBN: 978-3-642-11721-3

  • eBook Packages: Computer ScienceComputer Science (R0)

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