Clustering ICU patients with sepsis based on the patterns of their circulating biomarkers: A secondary analysis of the CAPTAIN prospective multicenter cohort study - Université de Versailles Saint-Quentin-en-Yvelines Access content directly
Journal Articles PLoS ONE Year : 2022

Clustering ICU patients with sepsis based on the patterns of their circulating biomarkers: A secondary analysis of the CAPTAIN prospective multicenter cohort study

Benoît Misset
François Philippart
Catherine Fitting
  • Function : Author
Jean-Pierre Bedos
  • Function : Author
Jean-Luc Diehl
  • Function : Author
Olfa Hamzaoui
  • Function : Author
Didier Journois
  • Function : Author
Marianna Parlato
  • Function : Author
Virginie Moucadel
  • Function : Author
Jean-Marc Cavaillon
  • Function : Author
Joël Coste
  • Function : Author

Abstract

Background Although sepsis is a life-threatening condition, its heterogeneous presentation likely explains the negative results of most trials on adjunctive therapy. This study in patients with sepsis aimed to identify subgroups with similar immune profiles and their clinical and outcome correlates. Methods A secondary analysis used data of a prospective multicenter cohort that included patients with early assessment of sepsis. They were described using Predisposition, Insult, Response, Organ failure sepsis (PIRO) staging system. Thirty-eight circulating biomarkers (27 proteins, 11 mRNAs) were assessed at sepsis diagnosis, and their patterns were determined through principal component analysis (PCA). Hierarchical clustering was used to group the patients and k -means algorithm was applied to assess the internal validity of the clusters. Results Two hundred and three patients were assessed, of median age 64.5 [52.0–77.0] years and SAPS2 score 55 [49–61] points. Five main patterns of biomarkers and six clusters of patients (including 42%, 21%, 17%, 9%, 5% and 5% of the patients) were evidenced. Clusters were distinguished according to the certainty of the causal infection, inflammation, use of organ support, pro- and anti-inflammatory activity, and adaptive profile markers. Conclusions In this cohort of patients with suspected sepsis, we individualized clusters which may be described with criteria used to stage sepsis. As these clusters are based on the patterns of circulating biomarkers, whether they might help to predict treatment responsiveness should be addressed in further studies. Trial registration The CAPTAIN study was registered on clinicaltrials.gov on June 22, 2011, # NCT01378169 .

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Health
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Dates and versions

hal-04552880 , version 1 (19-04-2024)

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Benoît Misset, François Philippart, Catherine Fitting, Jean-Pierre Bedos, Jean-Luc Diehl, et al.. Clustering ICU patients with sepsis based on the patterns of their circulating biomarkers: A secondary analysis of the CAPTAIN prospective multicenter cohort study. PLoS ONE, 2022, 17 (10), pp.e0267517. ⟨10.1371/journal.pone.0267517⟩. ⟨hal-04552880⟩
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