Effects of growth trajectory of shock index within 24 h on the prognosis of patients with sepsis
BackgroundSepsis is a serious disease with high clinical morbidity and mortality. Despite the tremendous advances in medicine and nursing, treatment of sepsis remains a huge challenge. Our purpose was to explore the effects of shock index (SI) trajectory changes on the prognosis of patients within 2...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.898424/full |
| _version_ | 1828322926752956416 |
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| author | Fengshuo Xu Fengshuo Xu Fengshuo Xu Luming Zhang Tao Huang Didi Han Rui Yang Shuai Zheng Aozi Feng Liying Huang Haiyan Yin Jun Lyu Jun Lyu Jun Lyu |
| author_facet | Fengshuo Xu Fengshuo Xu Fengshuo Xu Luming Zhang Tao Huang Didi Han Rui Yang Shuai Zheng Aozi Feng Liying Huang Haiyan Yin Jun Lyu Jun Lyu Jun Lyu |
| author_sort | Fengshuo Xu |
| collection | DOAJ |
| description | BackgroundSepsis is a serious disease with high clinical morbidity and mortality. Despite the tremendous advances in medicine and nursing, treatment of sepsis remains a huge challenge. Our purpose was to explore the effects of shock index (SI) trajectory changes on the prognosis of patients within 24 h after the diagnosis of sepsis.MethodsThis study was based on Medical Information Mart for Intensive Care IV (MIMIC- IV). The effects of SI on the prognosis of patients with sepsis were investigated using C-index and restricted cubic spline (RCS). The trajectory of SI in 24 h after sepsis diagnosis was classified by latent growth mixture modeling (LGMM). Cox proportional hazard model, double robust analysis, and subgroup analysis were conducted to investigate the influence of SI trajectory on in-hospital death and secondary outcomes.ResultsA total of 19,869 patients were eventually enrolled in this study. C-index showed that SI had a prognostic value independent of Sequential Organ Failure Assessment for patients with sepsis. Moreover, the results of RCS showed that SI was a prognostic risk factor. LGMM divided SI trajectory into seven classes, and patients with sepsis in different classes had notable differences in prognosis. Compared with the SI continuously at a low level of 0.6, the SI continued to be at a level higher than 1.0, and the patients in the class whose initial SI was at a high level of 1.2 and then declined had a worse prognosis. Furthermore, the trajectory of SI had a higher prognostic value than the initial SI.ConclusionBoth initial SI and trajectory of SI were found to be independent factors that affect the prognosis of patients with sepsis. Therefore, in clinical treatment, we should closely monitor the basic vital signs of patients and arrive at appropriate clinical decisions on basis of their change trajectory. |
| first_indexed | 2024-04-13T18:46:10Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-13T18:46:10Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-56d673ff206349a3af84f9bca807ecc82022-12-22T02:34:34ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-08-01910.3389/fmed.2022.898424898424Effects of growth trajectory of shock index within 24 h on the prognosis of patients with sepsisFengshuo Xu0Fengshuo Xu1Fengshuo Xu2Luming Zhang3Tao Huang4Didi Han5Rui Yang6Shuai Zheng7Aozi Feng8Liying Huang9Haiyan Yin10Jun Lyu11Jun Lyu12Jun Lyu13Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Nosocomial Infection Management, Luoyang Orthopedic-Traumatological Hospital, Orthopedics Hospital of Henan Province, Zhengzhou, ChinaSchool of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaSchool of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, ChinaSchool of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, ChinaSchool of Public Health, Shaanxi University of Chinese Medicine, Xianyang, ChinaDepartment of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, ChinaBackgroundSepsis is a serious disease with high clinical morbidity and mortality. Despite the tremendous advances in medicine and nursing, treatment of sepsis remains a huge challenge. Our purpose was to explore the effects of shock index (SI) trajectory changes on the prognosis of patients within 24 h after the diagnosis of sepsis.MethodsThis study was based on Medical Information Mart for Intensive Care IV (MIMIC- IV). The effects of SI on the prognosis of patients with sepsis were investigated using C-index and restricted cubic spline (RCS). The trajectory of SI in 24 h after sepsis diagnosis was classified by latent growth mixture modeling (LGMM). Cox proportional hazard model, double robust analysis, and subgroup analysis were conducted to investigate the influence of SI trajectory on in-hospital death and secondary outcomes.ResultsA total of 19,869 patients were eventually enrolled in this study. C-index showed that SI had a prognostic value independent of Sequential Organ Failure Assessment for patients with sepsis. Moreover, the results of RCS showed that SI was a prognostic risk factor. LGMM divided SI trajectory into seven classes, and patients with sepsis in different classes had notable differences in prognosis. Compared with the SI continuously at a low level of 0.6, the SI continued to be at a level higher than 1.0, and the patients in the class whose initial SI was at a high level of 1.2 and then declined had a worse prognosis. Furthermore, the trajectory of SI had a higher prognostic value than the initial SI.ConclusionBoth initial SI and trajectory of SI were found to be independent factors that affect the prognosis of patients with sepsis. Therefore, in clinical treatment, we should closely monitor the basic vital signs of patients and arrive at appropriate clinical decisions on basis of their change trajectory.https://www.frontiersin.org/articles/10.3389/fmed.2022.898424/fullsepsisshock indexgrowth trajectoryprognosislatent growth mixture modeling |
| spellingShingle | Fengshuo Xu Fengshuo Xu Fengshuo Xu Luming Zhang Tao Huang Didi Han Rui Yang Shuai Zheng Aozi Feng Liying Huang Haiyan Yin Jun Lyu Jun Lyu Jun Lyu Effects of growth trajectory of shock index within 24 h on the prognosis of patients with sepsis Frontiers in Medicine sepsis shock index growth trajectory prognosis latent growth mixture modeling |
| title | Effects of growth trajectory of shock index within 24 h on the prognosis of patients with sepsis |
| title_full | Effects of growth trajectory of shock index within 24 h on the prognosis of patients with sepsis |
| title_fullStr | Effects of growth trajectory of shock index within 24 h on the prognosis of patients with sepsis |
| title_full_unstemmed | Effects of growth trajectory of shock index within 24 h on the prognosis of patients with sepsis |
| title_short | Effects of growth trajectory of shock index within 24 h on the prognosis of patients with sepsis |
| title_sort | effects of growth trajectory of shock index within 24 h on the prognosis of patients with sepsis |
| topic | sepsis shock index growth trajectory prognosis latent growth mixture modeling |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.898424/full |
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