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Data-derived subtypes of delirium during critical illnessResearch in context

التفاصيل البيبلوغرافية
العنوان: Data-derived subtypes of delirium during critical illnessResearch in context
المؤلفون: Kelly M. Potter, Jason N. Kennedy, Chukwudi Onyemekwu, Niall T. Prendergast, Pratik P. Pandharipande, E Wesley Ely, Christopher Seymour, Timothy D. Girard
المصدر: EBioMedicine, Vol 100, Iss , Pp 104942- (2024)
بيانات النشر: Elsevier, 2024.
سنة النشر: 2024
المجموعة: LCC:Medicine
LCC:Medicine (General)
مصطلحات موضوعية: Delirium, Subtypes, Heterogeneity, Latent class analysis, Medicine, Medicine (General), R5-920
الوصف: Summary: Background: To understand delirium heterogeneity, prior work relied on psychomotor symptoms or risk factors to identify subtypes. Data-driven approaches have used machine learning to identify biologically plausible, treatment-responsive subtypes of other acute illnesses but have not been used to examine delirium. Methods: We conducted a secondary analysis of a large, multicenter prospective cohort study involving adults in medical or surgical ICUs with respiratory failure or shock who experienced delirium per the Confusion Assessment Method for the ICU. We used data collected before delirium diagnosis in an unsupervised latent class model to identify delirium subtypes and then compared demographics, clinical characteristics, and outcomes between subtypes in the final model. Findings: The 731 patients who developed delirium during critical illness had a median age of 63 [IQR, 54–72] years, a median Sequential Organ Failure Assessment score of 8.0 [6.0–11.0] and 613 [83.4%] were mechanically ventilated at delirium identification. A four-class model best fit the data with 50% of patients in subtype (ST) 1, 18% in subtype 2, 17% in subtype 3, and 14% in subtype 4. Subtype 2—which had more shock and kidney impairment—had the highest mortality (33% [ST2] vs. 17% [ST1], 25% [ST3], and 17% [ST4], p = 0.003). Subtype 4—which received more benzodiazepines and opioids—had the longest duration of delirium (6 days [ST4] vs. 3 [ST1], 4 [ST2], and 3 days [ST3], p
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2352-3964
Relation: http://www.sciencedirect.com/science/article/pii/S235239642300508X; https://doaj.org/toc/2352-3964
DOI: 10.1016/j.ebiom.2023.104942
URL الوصول: https://doaj.org/article/cc520dd1c1d545d68d1c1dc5a2e0c85e
رقم الأكسشن: edsdoj.520dd1c1d545d68d1c1dc5a2e0c85e
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:23523964
DOI:10.1016/j.ebiom.2023.104942