Six subphenotypes in septic shock: Latent class analysis of the PROWESS Shock study.

Published

Journal Article

PURPOSE: Septic shock is a highly heterogeneous condition which is part of the challenge in its diagnosis and treatment. In this study we aim to identify clinically relevant subphenotypes of septic shock using a novel statistic al approach. METHODS: Baseline patient data from a large global clinical trial of septic shock (n = 1696) was analysed using latent class analysis (LCA). This approach allowed investigators to identify subgroups in a heterogeneous population by estimating a categorical latent variable that detects relatively homogeneous subgroups within a complex phenomenon. RESULTS: LCA identified six different, clinically meaningful subphenotypes of septic shock each with a typical profile: (1) "Uncomplicated Septic Shock, (2) "Pneumonia with adult respiratory distress syndrome (ARDS)", (3) "Postoperative Abdominal", (4) "Severe Septic Shock", (5): "Pneumonia with ARDS and multiple organ dysfunction syndrome (MODS)", (6) "Late Septic Shock". The 6-class solution showed high entropy approaching 1 (i.e., 0.92), indicating there was excellent separation between estimated classes. CONCLUSIONS: LCA appears to be an applicable statistical tool in analysing a heterogenous clinical cohort of septic shock. The results may lead to a better understanding of septic shock complexity and form a basis for considering targeted therapies and selecting patients for future clinical trials.

Full Text

Duke Authors

Cited Authors

  • Gårdlund, B; Dmitrieva, NO; Pieper, CF; Finfer, S; Marshall, JC; Taylor Thompson, B

Published Date

  • October 2018

Published In

Volume / Issue

  • 47 /

Start / End Page

  • 70 - 79

PubMed ID

  • 29933169

Pubmed Central ID

  • 29933169

Electronic International Standard Serial Number (EISSN)

  • 1557-8615

Digital Object Identifier (DOI)

  • 10.1016/j.jcrc.2018.06.012

Language

  • eng

Conference Location

  • United States