Identifying Novel Sepsis Subphenotypes Using Temperature Trajectories.

American Journal of Respiratory and Critical Care Medicine
Sivasubramanium V BhavaniMatthew M Churpek

Abstract

Rationale: Sepsis is a heterogeneous syndrome, and identifying clinically relevant subphenotypes is essential.Objectives: To identify novel subphenotypes in hospitalized patients with infection using longitudinal temperature trajectories.Methods: In the model development cohort, inpatient admissions meeting criteria for infection in the emergency department and receiving antibiotics within 24 hours of presentation were included. Temperature measurements within the first 72 hours were compared between survivors and nonsurvivors. Group-based trajectory modeling was performed to identify temperature trajectory groups, and patient characteristics and outcomes were compared between the groups. The model was then externally validated at a second hospital using the same inclusion criteria.Measurements and Main Results: A total of 12,413 admissions were included in the development cohort, and 19,053 were included in the validation cohort. In the development cohort, four temperature trajectory groups were identified: "hyperthermic, slow resolvers" (n = 1,855; 14.9% of the cohort); "hyperthermic, fast resolvers" (n = 2,877; 23.2%); "normothermic" (n = 4,067; 32.8%); and "hypothermic" (n = 3,614; 29.1%). The hypothermic subjects were the ...Continue Reading

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Citations

Mar 9, 2019·American Journal of Respiratory and Critical Care Medicine·Hallie C Prescott
Sep 13, 2019·Nature Reviews. Nephrology·Natalja L Stanski, Hector R Wong
Sep 14, 2019·American Journal of Respiratory and Critical Care Medicine·Souvik Maitra, Sulagna Bhattacharjee
Sep 14, 2019·American Journal of Respiratory and Critical Care Medicine·Sivasubramanium V BhavaniMatthew M Churpek
Mar 17, 2020·American Journal of Respiratory and Critical Care Medicine·Yaseen M ArabiHasan M Al-Dorzi
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Jul 25, 2020·Chest·Sivasubramanium V BhavaniMatthew M Churpek
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Feb 1, 2022·Critical Care Medicine·Sivasubramanium V BhavaniCraig M Coopersmith

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