Rapid and robust identification of sepsis using SeptiCyte RAPID in a heterogenous patient population

Robert Balk, Annette M Esper, Greg S Martin, Russell R Miller, Bert K Lopansri, John P Burke, Mitchell Levy, Richard E Rothman, Franco R d'Alessio, Venkataramana K Sidhaye, Neil R Aggarwal, Jared A Greenberg, Mark Yoder, Gourang Patel, Emily Gilbert, Jorge P Parada, Majid Afshar, Jordan A Kempker, Tom van der Poll, Marcus J Schultz, Brendon P Scicluna, Peter M C Klein-Klouwenberg, Janice Liebler, Emily Blodget, Santhi Kumar, Winnie Mei, Krupa Navalkar, Thomas D Yager, Dayle Sampson, James T Kirk, Silvia Cermelli, Roy F Davis, Richard B Brandon
{"title":"Rapid and robust identification of sepsis using SeptiCyte RAPID in a heterogenous patient population","authors":"Robert Balk, Annette M Esper, Greg S Martin, Russell R Miller, Bert K Lopansri, John P Burke, Mitchell Levy, Richard E Rothman, Franco R d'Alessio, Venkataramana K Sidhaye, Neil R Aggarwal, Jared A Greenberg, Mark Yoder, Gourang Patel, Emily Gilbert, Jorge P Parada, Majid Afshar, Jordan A Kempker, Tom van der Poll, Marcus J Schultz, Brendon P Scicluna, Peter M C Klein-Klouwenberg, Janice Liebler, Emily Blodget, Santhi Kumar, Winnie Mei, Krupa Navalkar, Thomas D Yager, Dayle Sampson, James T Kirk, Silvia Cermelli, Roy F Davis, Richard B Brandon","doi":"10.1101/2024.08.26.24312552","DOIUrl":null,"url":null,"abstract":"Background: SeptiCyte RAPID is a transcriptional host response assay that discriminates between sepsis and non-infectious systemic inflammation (SIRS) with a one-hour turnaround time. The overall performance of this test in a cohort of 419 patients has recently been described [Balk et al., J Clin Med 2024, 13, 1194]. In this study we present results from a detailed stratification analysis in which SeptiCyte RAPID performance was evaluated in the same cohort across patient groups and subgroups encompassing different demographics, comorbidities and disease, sources and types of pathogens, interventional treatments, and clinically defined phenotypes. The aims were to identify variables that might affect the ability of SeptiCyte RAPID to discriminate between sepsis and SIRS, and to determine if any patient subgroups appeared to present a diagnostic challenge for the test. Methods: 1) Subgroup analysis, with subgroups defined by individual demographic or clinical variables, using conventional statistical comparison tests. 2) Principal component analysis and k-means clustering analysis, to investigate phenotypic subgroups defined by unique combinations of demographic and clinical variables. Results: No significant differences in SeptiCyte RAPID performance were observed between most groups and subgroups. One notable exception involved an enhanced SeptiCyte RAPID performance for a phenotypic subgroup defined by a combination of clinical variables suggesting a septic shock response. Conclusions: We conclude that for this patient cohort SeptiCyte RAPID performance was largely unaffected by key variables associated with heterogeneity in patients suspected of sepsis.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"medRxiv - Intensive Care and Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1101/2024.08.26.24312552","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: SeptiCyte RAPID is a transcriptional host response assay that discriminates between sepsis and non-infectious systemic inflammation (SIRS) with a one-hour turnaround time. The overall performance of this test in a cohort of 419 patients has recently been described [Balk et al., J Clin Med 2024, 13, 1194]. In this study we present results from a detailed stratification analysis in which SeptiCyte RAPID performance was evaluated in the same cohort across patient groups and subgroups encompassing different demographics, comorbidities and disease, sources and types of pathogens, interventional treatments, and clinically defined phenotypes. The aims were to identify variables that might affect the ability of SeptiCyte RAPID to discriminate between sepsis and SIRS, and to determine if any patient subgroups appeared to present a diagnostic challenge for the test. Methods: 1) Subgroup analysis, with subgroups defined by individual demographic or clinical variables, using conventional statistical comparison tests. 2) Principal component analysis and k-means clustering analysis, to investigate phenotypic subgroups defined by unique combinations of demographic and clinical variables. Results: No significant differences in SeptiCyte RAPID performance were observed between most groups and subgroups. One notable exception involved an enhanced SeptiCyte RAPID performance for a phenotypic subgroup defined by a combination of clinical variables suggesting a septic shock response. Conclusions: We conclude that for this patient cohort SeptiCyte RAPID performance was largely unaffected by key variables associated with heterogeneity in patients suspected of sepsis.
使用 SeptiCyte RAPID 在异质患者群体中快速、稳健地识别败血症
背景介绍SeptiCyte RAPID 是一种转录宿主反应检测方法,可在一小时内区分败血症和非感染性全身炎症(SIRS)。最近描述了该检测方法在 419 例患者中的总体表现[Balk 等人,J Clin Med 2024,13,1194]。在本研究中,我们介绍了详细的分层分析结果,其中对同一队列中不同患者组和亚组(包括不同的人口统计学特征、合并症和疾病、病原体的来源和类型、介入治疗和临床定义的表型)的 SeptiCyte RAPID 性能进行了评估。目的是确定可能影响 SeptiCyte RAPID 鉴别败血症和 SIRS 的能力的变量,并确定是否有任何患者亚组似乎对该检验的诊断构成挑战。方法:1)使用常规统计比较测试进行亚组分析,亚组由个人人口统计学或临床变量定义。2) 主成分分析和 K-均值聚类分析,研究由人口统计学和临床变量的独特组合所定义的表型亚组。结果大多数组别和亚组之间的 SeptiCyte RAPID 性能没有明显差异。一个值得注意的例外是,由临床变量组合定义的表型亚组的SeptiCyte RAPID性能增强,这表明该亚组存在脓毒性休克反应。结论我们得出的结论是,在这一患者群中,SeptiCyte RAPID的性能基本不受与疑似败血症患者异质性相关的关键变量的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信