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Sepsis-induced Coagulopathy Subphenotype Identification by Latent Class Analysis
Dan Cai1, Massimiliano Greco2,3, Qin Wu1
1Department of Critical Care Medicine, West China Hospital, Sichuan University, Sichuan, China
Balkan Medical Journal
|June 2, 2023
Summary
Researchers identified three distinct patient groups with sepsis-induced coagulopathy (SIC). Anticoagulant therapy, specifically heparin, was found to reduce mortality only in one specific SIC subphenotype, guiding targeted treatment.
Area of Science:
- Critical Care Medicine
- Hematology
- Translational Research
Background:
- Sepsis-induced coagulopathy (SIC) exhibits varied responses to anticoagulant therapy.
- Identifying distinct patient subgroups within SIC is crucial for optimizing treatment strategies.
Purpose of the Study:
- To identify latent phenotypes (subtypes) of patients diagnosed with sepsis-induced coagulopathy (SIC).
- To investigate the differential effects of anticoagulant therapy across identified SIC subphenotypes.
Main Methods:
- Retrospective cohort study utilizing data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.
- Latent class analysis (LCA) and K-means clustering were employed to identify SIC subphenotypes.
- Clinical and laboratory variables were analyzed to characterize subphenotypes and assess treatment outcomes.
Main Results:
- Three distinct SIC subphenotypes were identified among 4,993 patients.
- Subphenotype 2 characterized by severe coagulopathy, organ dysfunction, and high mortality, showed significant mortality reduction with heparin therapy (28-day OR 0.39, in-hospital OR 0.42).
- Other subphenotypes demonstrated different clinical profiles and did not show a significant benefit from heparin therapy.
Conclusions:
- The study defined three clinically and laboratory-distinct subphenotypes of SIC.
- Heparin therapy demonstrated a significant survival benefit exclusively in the severe coagulopathy subphenotype (Class 2).
- These findings support personalized anticoagulant therapy selection for patients with SIC based on their specific subphenotype.
