Skip to main content

On the Use of Graphical Models to Study ICU Outcome Prediction in Septic Patients Treated with Statins

  • Conference paper
Computational Intelligence Methods for Bioinformatics and Biostatistics (CIBB 2011)

Abstract

Sepsis is a common pathology in Intensive Care Units (ICU). At its most acute phase, namely septic shock, mortality rates can be as high as 60%. Early administration of antibiotics is known to be crucial for ICU outcomes. In particular, statins, a class of drug usually associated to the regulation of the biosynthesis of cholesterol, have been shown to present good anti-inflammatory properties. In this brief study, we hypothesized that the pre-admission use of statins should improve ICU outcomes, reducing the mortality rate. We tested this hypothesis in a prospective study with patients admitted with severe sepsis and multi-organ failure at the ICU of Vall d’Hebrón University Hospital (Barcelona, Spain). Outcome was predicted using statistic algebraic models and the Bayesian Networks that can naturally be derived from these models.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 72.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  1. Livingston, D.H., Mosenthal, A.C., Deith, E.A.: Sepsis and multiple organ dysfunction syndrome: A clinical-mechanistic overview. New Horizons 3, 257–266 (1995)

    Google Scholar 

  2. 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. Crit. Care Med. 20, 864–874 (1992)

    Google Scholar 

  3. Levy, M.M., Fink, M.P., Marshall, J.C., Edward Angus, A., Cook, D., Cohen, J., Opal, S.M., Vincent, J.L., Ramsay, G.: 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intensive Care Med. 29, 530–538 (2003)

    Google Scholar 

  4. Esteban, A., Frutos-Vivar, F., Ferguson, N., Penuelas, O., Lorente, J., Al, G.F., Honrubia, T., Algora, A., Bustos, A., Garcia, G., Rodriguez, I., Ruiz, R.: Sepsis incidence and outcome: contrasting the intensive care unit with the hospital ward. Crit. Care Med. 35(5), 1284–1289 (2007)

    Article  Google Scholar 

  5. Angus, D.C., Linde-Zwirble, W.T., Lidicker, J., Clermont, G.L., Carcillo, J., Pinski, M.R.: Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit. Care Med. 29(7), 1303–1310 (2001)

    Article  Google Scholar 

  6. Martin, G.S., Mannino, D.M., Eaton, S., Ross, M.: The epidemiology of sepsis in the United States from 1979 through 2000. N. Eng. J. Med. 348(16), 1546–1554 (2003)

    Article  Google Scholar 

  7. Almog, Y., Novack, V., Eisinger, M., Porath, A., Novack, L., Gilutz, H.: The effect of statin therapy on infection-related mortality in patients with atherosclerotic diseases. Crit. Care Med. 35, 372–378 (2007)

    Article  Google Scholar 

  8. Chopra, V., Flanders, S.A.: Does Statin Use Improve Pneumonia Outcomes? Chest 136, 1381–1388 (2009)

    Article  Google Scholar 

  9. Gao, F., Linhartova, L., Johnston, M., Thickett, D.R.: Statins and sepsis. Br J. Anaesth 100, 288–298 (2008)

    Article  Google Scholar 

  10. Thomsen, R.W., Hundborg, H.H., Johnsen, S.P.J., Pedersen, L., Sorensen, H.T., Schonheyder, H.C., Lervang, H.H.: Statin use and mortality within 180 days after bacteremia: A population-based cohort study. Crit. Care Med. 34, 1080–1086 (2006)

    Article  Google Scholar 

  11. Tleyjeh, I.M., Kashour, T., Hakim, F.A., Zimmerman, V.A., Erwin, P.J., Sutton, A.J., Ibrahim, T.: Statins for the prevention and treatment of infections. A systematic review and meta-analysis. Arch. Intern. Med. 169, 1658–1667 (2009)

    Article  Google Scholar 

  12. Christensen, S., Thomsen, R.W., Johansen, M.B., Pedersen, L., Jensen, R., Larsen, K.M., Larsson, A., Tonnesen, E., Sorensen, H.T.: Preadmission statin use and one-year mortality among patients in intensive care. A cohort study. Crit. Care 14, 29 (2010)

    Article  Google Scholar 

  13. Schmidt, H., Hennen, R., Keller, A., Russ, M., Muller-Werdan, U., Werdan, K., Buerke, M.: Association of statin therapy and increased survival in patients with multiple organ dysfunction syndrome. Intensive Care Med. 32, 1248–1251 (2006)

    Article  Google Scholar 

  14. Majumdar, S.R., McAlister, F.A., Eurich, D.T., Padwal, R.S., Marrie, T.J.: Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study. BMJ 333(7576), 999–1001 (2006)

    Article  Google Scholar 

  15. Kapoor, A.S., Kanji, H., Buckingham, J., Devereaux, P.J., McAlister, F.A.: Strength of evidence for perioperative use of statins to reduce cardiovascular risk: systematic review of controlled studies. BMJ 333, 1149 (2006)

    Article  Google Scholar 

  16. Fernandez, R., De Pedro, V.J., Artigas, A.: Statin therapy prior to ICU admission: protection against infection or a severity marker? Intensive Care Med. 32, 160–164 (2006)

    Article  Google Scholar 

  17. Bellazzi, R., Zupan, B.: Predictive data mining in clinical medicine: Current issues and guidelines. International Journal of Medical Informatics 77, 81–97 (2008)

    Article  Google Scholar 

  18. Vincent, J.L., Moreno, R., Takala, J., Willats, S., De Mendoça, A., Bruining, H., Reinhart, C.K., Suter, P.M., Thijs, L.G.: The SOFA (Sepsis Related Organ Failure Assessment) Score to describe organ dysfunction/failure. Intensive Care Med. 22, 707–710 (1996)

    Article  Google Scholar 

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

    Article  Google Scholar 

  20. Lopes Ferreira, F., Peres Bota, D., Bross, A., Melot, C., Vincent, J.L.: Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patients. JAMA 286, 1754–1758 (2001)

    Article  Google Scholar 

  21. Pachter, M., Sturmfels, B.: Algebraic Statistics for Computational Biology. Cambridge University Press (2005)

    Google Scholar 

  22. Pistone, G., Riccomagno, E., Wynn, H.P.: Algebraic Statistics: Computational Commutative Algebra in Statistics. Chapman and Hall, CRC Press (2001)

    Google Scholar 

  23. Lauritzen, S.: Graphical Models. Oxford University Press (1996)

    Google Scholar 

  24. Geiger, D., Meek, C., Sturmfels, B.: On the Toric Algebra of Graphical Models. Ann. Statist. 34(3), 1463–1492 (2006)

    Article  MathSciNet  MATH  Google Scholar 

  25. Hammersley, J.M., Clifford P.: Markov Fields on Finite Graphs and Lattices (1971) (unpublished manuscript), http://www.statslab.cam.ac.uk/~grg/books/hammfest/hamm-cliff.pdf

  26. Hastie, T., Tibshirani, R., Friedman, J.: The Elements of Statistical Learning: Data Mining, Inference, and Prediction, 2nd edn. Springer Series in Statistics. Springer (2009)

    Google Scholar 

  27. Breiman, L., Friedman, J., Stone, C.J.: Classification and Regression Trees. Chapman and Hall/CRC (1984)

    Google Scholar 

  28. Golub, G.H., Reinsch, C.: Singular value decomposition and least squares solutions. Numer. Math. 14(5), 403–420 (1970)

    Article  MathSciNet  MATH  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Ribas, V.J. et al. (2012). On the Use of Graphical Models to Study ICU Outcome Prediction in Septic Patients Treated with Statins. In: Biganzoli, E., Vellido, A., Ambrogi, F., Tagliaferri, R. (eds) Computational Intelligence Methods for Bioinformatics and Biostatistics. CIBB 2011. Lecture Notes in Computer Science(), vol 7548. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35686-5_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-35686-5_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-35685-8

  • Online ISBN: 978-3-642-35686-5

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics