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Orthogonal Trajectories01:26

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Orthogonal trajectories describe the geometric relationship between two families of curves that intersect each other at right angles. One illustrative case involves a family of parabolas that open sideways along the x-axis. These curves share a common shape but differ by a scaling parameter, resulting in a set of curves that all pass through the origin and widen at different rates.Determining Orthogonal TrajectoriesTo identify the orthogonal trajectories for these parabolas, the first step...
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A Data-Driven Approach to Quantifying Immune States in Sepsis
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Identifying Novel Sepsis Subphenotypes Using Temperature Trajectories.

Sivasubramanium V Bhavani1, Kyle A Carey1, Emily R Gilbert2

  • 11Department of Medicine and.

American Journal of Respiratory and Critical Care Medicine
|February 22, 2019
PubMed
Summary
This summary is machine-generated.

Researchers identified four distinct patient subphenotypes based on temperature patterns in hospitalized infections. These sepsis subphenotypes show varied inflammatory markers and significantly different mortality rates, aiding personalized treatment strategies.

Keywords:
group-based trajectory modelinginfectionsepsistemperature

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Area of Science:

  • Clinical Medicine
  • Infectious Diseases
  • Critical Care

Background:

  • Sepsis is a complex, heterogeneous syndrome requiring precise subphenotyping for effective management.
  • Understanding patient-specific responses to infection is crucial for improving clinical outcomes.

Purpose of the Study:

  • To identify novel subphenotypes in hospitalized patients with infection using longitudinal temperature trajectories.
  • To analyze the relationship between temperature patterns, inflammatory markers, and patient outcomes.

Main Methods:

  • Utilized group-based trajectory modeling on longitudinal temperature data from over 12,000 inpatient admissions.
  • Included patients meeting infection criteria and receiving antibiotics within 24 hours.
  • Externally validated findings in a separate cohort of over 19,000 patients.

Main Results:

  • Identified four distinct temperature trajectory subphenotypes: 'hyperthermic, slow resolvers', 'hyperthermic, fast resolvers', 'normothermic', and 'hypothermic'.
  • The 'hypothermic' group exhibited the highest mortality (9.5%), while 'hyperthermic, fast resolvers' had the lowest (2.9%).
  • Significant differences in age, comorbidities, inflammatory markers, and mortality were observed across the identified subphenotypes.

Conclusions:

  • Four novel, validated subphenotypes of patients with infection were identified based on temperature trajectories.
  • These subphenotypes demonstrate distinct clinical characteristics, inflammatory profiles, and prognoses.
  • Findings support the potential for personalized medicine approaches in managing infectious diseases.