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败血症亚型的模糊分类以及对轨迹和治疗的影响
Jason N Kennedy1, Stuthi Iyer2, Peter C Nauka3
1Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
EBioMedicine
|January 20, 2026
概括
败血症亚型是动态的,分类不确定性会影响治疗. 患有不确定的亚型分类的患者更有可能改变组,影响治疗结果.
科学领域:
- 临界护理医学 临界护理医学
- 计算生物学 计算生物学
- 翻译医学是一种翻译医学.
背景情况:
- 败血症是一种危及生命的疾病,为精确治疗提出了亚型.
- 了解败血症亚型分类中的不确定性对于预测患者轨迹和治疗反应至关重要.
研究的目的:
- 调查临床败血症亚型分类中的不确定性.
- 确定这种不确定性对亚型动态和死亡率的影响.
主要方法:
- 将临床败血症亚型 (α,β,γ,δ) 分配给成人败血症患者,使用电子健康记录和试验数据.
- 根据会员概率定义核心 (≥90%) 和边缘 (<90%) 层.
- 通过逻辑回归分析了亚型,层,48小时内的亚型变化和365天死亡率之间的关联.
主要成果:
- 包括35691名社区获得性败血症的成年患者.
- 82%的患者在48小时内改变了临床败血症亚型.
- 大多数患者落入边缘层,在这些组中观察到亚型变化的几率增加和治疗对死亡率的影响改变.
结论:
- 临床败血症亚型是动态的,分类不确定性很大.
- 被归类为边缘层的患者更容易发生亚型变化.
- 败血症亚型分类的不确定性会影响治疗的有效性.
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