학술논문
Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort
Document Type
Report
Author
Ceccato, Adrian; Forne, Carles; Bos, Lieuwe D.; Camprubí-Rimblas, Marta; Areny-Balagueró, Aina; Campaéa-Duel, Elena; Quero, Sara; Diaz, Emili; Roca, Oriol; De Gonzalo-Calvo, David; Fernández-Barat, Laia; Motos, Anna; Ferrer, Ricard; Riera, Jordi; Lorente, Jose A.; Peéuelas, Oscar; Menendez, Rosario; Amaya-Villar, Rosario; Aéón, José M.; Balan-Mariéo, Ana; Barberà, Carme; Barberán, José; Blandino-Ortiz, Aaron; Boado, Maria Victoria; Bustamante-Munguira, Elena; Caballero, Jesús; Carbajales, Cristina; Carbonell, Nieves; Catalán-González, Mercedes; Franco, Nieves; Galbán, Cristóbal; Gumucio-Sanguino, Víctor D.; de la Torre, Maria del Carmen; Estella, Ãngel; Gallego, Elena; García-Garmendia, José Luis; Garnacho-Montero, José; Gómez, José M.; Huerta, Arturo; Jorge-García, Ruth Noemí; Loza-Vázquez, Ana; Marin-Corral, Judith; Martínez de la Gándara, Amalia; Martin-Delgado, María Cruz; Martínez-Varela, Ignacio; Messa, Juan Lopez; Muéiz-Albaiceta, Guillermo; Nieto, María Teresa; Novo, Mariana Andrea; Peéasco, Yhivian; Pozo-Laderas, Juan Carlos; Pérez-García, Felipe; Ricart, Pilar; Roche-Campo, Ferran; Rodríguez, Alejandro; Sagredo, Victor; Sánchez-Miralles, Angel; Sancho-Chinesta, Susana; Socias, Lorenzo; Solé-Violan, Jordi; Suarez-Sipmann, Fernando; Tamayo-Lomas, Luis; Trenado, José; Ãbeda, Alejandro; Valdivia, Luis Jorge; Vidal, Pablo; Bermejo, Jesus; Gonzalez, Jesica; Barbe, Ferran; Calfee, Carolyn S.; Artigas, Antonio; Torres, Antoni; Adell-Serrano, Berta; Cabello, María Aguilar; Aguilera, Luciano; Alcaraz-Serrano, Victoria; Aldecoa, Cesar; Alegre, Cynthia; Almansa, Raquel; Ãlvarez, Sergio; Ruiz, Antonio Ãlvarez; Villar, Rosario Amaya; Andrea, Ruth; Ãngel, José; Aéon, Jose Manuel; Arrieta, Marta; Ayestarán, JIgnacio; Badia, Joan Ramon; Badía, Mariona; Pravia, Orville Báez; Mariéo, Ana Balan; Balsera, Begoéa; Barbena, Laura; Barbeta, Enric; Bardi, Tommaso; Segade, Patricia Barral; Barroso, Marta; García, José Ãngel Berezo; Bermejo-Martin, Jesús F.; Beteré, Belén; Bigas, Judit; Ortiz, Aaron Blandino; Blancas, Rafael; Cortés, María Luisa Blasco; Boado, María; Saera, María Bodi; Bofill, Neus; Vieiro, María Teresa Bouza; Bueno, Leticia; Bustamante-Munguira, Juan; del Busto Martínez, Cecilia; Hermoso, David Campi; Fernández, Sandra Campos; Cano, Iosune; Cantón-Bulnes, Maria Luisa; Fernández, Pablo Cardina; García, Laura Carrión; Carvalho, Sulamita; Casacuberta-Barberà, Núria; Castellà, Manuel; Castellví, Andrea; Castro, Pedro; Ãvila, Ramon Cicuendez; Cillóniz, Catia; Clar, Luisa; Climent, Cristina; Codina, Jordi; Conde, Pamela; Contreras, Sofía; Martin, María Cruz; de Pablo Sánchez, Raul; De Mendoza, Diego; Díaz, Emili; Díaz, Yolanda; Vilas, María Digna Rivas; Moreno, Cristina Dólera; Dot, Irene; Giraudo, Pedro Enríquez; Arijón, Inés Esmorís; Estella, Angel; Monjo, Teresa Farre; Fernández, Javier; Ferrando, Carlos; Figueras, Albert; Forcadell-Ferreres, Eva; Espina, Lorena Forcelledo; Franquesa, Enric; Furro, Ãngels; Gabarrus, Albert; García, Felipe; García, Beatriz; Garmendia, José Luis García; Garcia-Gasulla, Dario; Prieto, Emilio García; Redruello, Carlos García; Sagastume, Amaia García; Castillo, Maria Luisa Gascón; Gomà, Gemma; Casal, Vanesa Gómez; Gómez, Silvia; Gonzalez, Carmen Gómez; de Gonzalo-Calvo, David; González, Jessica; Gordo, Federico; Gracia, Maria Pilar; Herraiz, Alba; Herrán-Monge, Rubén; Ibarz, Mercedes; Iglesias, Silvia; Janer, Maria Teresa; Jiménez, Gabriel; García, Ruth Noemí Jorge; Díaz, Mar Juan; Kiarostami, Karsa; Ãlvarez, Juan ILazo; León, Miguel; López-Gavín, Alexandre; Lago, Ana López; López-Ramos, Esther; Guerrero, Desire Macias; Herrera, Nuria Mamolar; Mendiluce, Rafael Maéez; Mantellini, Cecilia L.; Naya, Gregorio Marco; Marcos, Pilar; Peis, Enrique Marmol; Vicente, Paula Martín; Martínez, María; Fernández, Carmen Eulalia Martínez; de la Gándara, Amalia Martínez; Juan, Maria Dolores Martínez; Palacios, Basilisa Martínez; Varela, Ignacio Martínez; Jimenez, Juan Fernando Masa; Masclans, Joan Ramon; Maseda, Emilio; Fernández, Eva María Menor; Miralbés, Mar; Monclou, Josman; Montejo-González, Juan Carlos; Montserrat, Neus; Aznar, María Mora; Morales, Dulce; Cano, Sara Guadalupe Moreno; Rodríguez, David Mosquera; Muéoz-Bermúdez, Rosana; Albaiceta, Guillermo Muéiz; Nicolás, José María; NIeto, Maria Teresa; Bou, Ramon Nogue; Salinas, Rafaela Nogueras; Ocón, Marta; Ortega, Ana; Ossa, Sergio; Pagliarani, Pablo; Parrilla, Francisco; Pedregosa-Díaz, Jose; Bastida, Leire Pérez; Pérez, Purificación; Planelles, Gloria Pérez; Rubio, Eva Pérez; Laguna, David Pestaéa; Piéol-Tena, Ãngels; Prados, Javier; Pujol, Andrés; Pozo, Juan Carlos; Coll, Núria Ramon; Sanchez-Giron, Gloria Renedo; Rodriguez, Laura; de Castro, Felipe Rodríguez; Rodríguez, Silvia; Ruiz, Covadonga Rodríguez; Rubio, Jorge; López, Alberto Rubio; Ruiz-García, Ãngela Leonor; Miralles, Miriam Ruiz; Murúa, Pablo Ryan; Paz, Eva Saborido; Degracia, Ana Salazar; Salvador-Adell, Inmaculada; Sanchez, Miguel; Sánchez, Ana; Chinesta, Susana Sancho; Santacoloma, Bitor; Sariéena, Maria Teresa; Pensado, Marta Segura; Serra, Lidia; Serra-Fortuny, Mireia; Lázaro, Ainhoa Serrano; Servià, Lluís; Soliva, Laura; Sipmann, Fernando Suarez; Speziale, Carla; Lomas, Luis Tamayo; Tormos, Adrián; Torres, Gerard; Torres, Mateu; Trefler, Sandra; Trenado, Josep; Trujillano, Javier; Urrelo-Cerrón, Luis; Val, Estela; Valledor, Manuel; Ruiz, Luis Valdivia; Vallverdú, Montserrat; Van der Hofstadt Martin-Montalvo, Maria; Adrio, Sabela Vara; Vázquez, Nil; Vengoechea, Javier; Vilà-Vilardel, Clara; Vilanova, Judit; Warrington, Tatiana Villada; Yang, Hua; Yang, Minlan; Zapatero, Ana
Source
Critical Care. March 21, 2024, Vol. 28 Issue 1
Subject
Language
English
ISSN
1364-8535
Abstract
Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster. Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3. Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3. Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis. Keywords: ARDS, Clustering, Mortality, Precision medicine
Author(s): Adrian Ceccato[sup.1,2,3] , Carles Forne[sup.4,5] , Lieuwe D. Bos[sup.6] , Marta Camprubí-Rimblas[sup.1,2] , Aina Areny-Balagueró[sup.1,2] , Elena Campaéa-Duel[sup.1,2] , Sara Quero[sup.1,2] , Emili Diaz[sup.1,2] , Oriol Roca[sup.1,2] , David [...]
Author(s): Adrian Ceccato[sup.1,2,3] , Carles Forne[sup.4,5] , Lieuwe D. Bos[sup.6] , Marta Camprubí-Rimblas[sup.1,2] , Aina Areny-Balagueró[sup.1,2] , Elena Campaéa-Duel[sup.1,2] , Sara Quero[sup.1,2] , Emili Diaz[sup.1,2] , Oriol Roca[sup.1,2] , David [...]