Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort
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 cha...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| Repositorio: | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| OAI Identifier: | oai:i3pt.fundanetsuite.com:p5076 |
| Acceso en línea: | https://i3pt.portalinvestigacion.com/publicaciones/5076 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85188329150&doi=10.1186%2fs13054-024-04876-5&partnerID=40&md5=936b0eafc71a903809927bd4ff59ba5d |
| Access Level: | acceso abierto |
| Palabra clave: | ARDS Clustering Mortality Precision medicine |
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| dc.title.none.fl_str_mv |
Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort |
| title |
Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort |
| spellingShingle |
Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort Ceccato, A ARDS Clustering Mortality Precision medicine |
| title_short |
Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort |
| title_full |
Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort |
| title_fullStr |
Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort |
| title_full_unstemmed |
Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort |
| title_sort |
Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort |
| dc.creator.none.fl_str_mv |
Ceccato, A Forne, C Bos, LD Camprubi-Rimblas, M Areny-Balaguero, A Campana-Duel, E Quero, S Roca, O De Gonzalo-Calvo, D Fernandez-Barat, L Motos, A Ferrer, R Lorente, JA Menendez, R Amaya-Villar, R Anon, JM Balan-Marino, A Blandino-Ortiz, A Boado, MV Garcia-Garmendia, JL Jorge-Garcia, RN de la Gandara, AM Martin-Delgado, MC Martinez-Varela, I Muniz-Albaiceta, G Pozo-Laderas, JC Sancho-Chinesta, S Suarez-Sipmann, F Tamayo-Lomas, L Trenado, J Valdivia, LJ Bermejo, J Gonzalez, J Barbe, F Calfee, CS Artigas, A Torres, A Adell-Serrano, B Cabello, MA Aguilera, L Alcaraz-Serrano, V Aldecoa, C Alegre, C Almansa, R Alvarez, S Ruiz, AA Villar, RA Andrea, R Novo, MA Angel, J Anon, JM Arrieta, M Ayestaran, J Badia, JR Badia, M Pravia, OB Marino, AB Balsera, B Barbera, C Barberan, J Barbena, L Barbeta, E Bardi, T Segade, PB Barroso, M Garcia, JAB Bermejo-Martin, JF Betere, B Bigas, J Ortiz, AB Blancas, R Cortes, MLB Boado, M Saera, MB Bofill, N Vieiro, MTB Bueno, L Bustamante-Munguira, E Bustamante-Munguira, J Martinez, CD Caballero, J Hermoso, DC Fernandez, SC Carbajales, C Cano, I Canton-Bulnes, ML Carbonell, N Fernandez, PC Garcia, LC Carvalho, S Casacuberta-Barbera, N Castella, M Castellvi, A Castro, P Catalan-Gonzalez, M Avila, RC Cilloniz, C Clar, L Climent, C Codina, J Conde, P Contreras, S Martin, MC Sanchez, RD De Mendoza, D Diaz, E Diaz, Y Vilas, MDR Moreno, CD Dot, I Giraudo, PE Arijon, IE Estella, A Monjo, TF Fernandez, J Ferrando, C Figueras, A Forcadell-Ferreres, E Espina, LF Franco, N Franquesa, E Furro, A Gabarrus, A Galban, C Gallego, E Garcia, F Garcia, B Garmendia, JLG Garcia-Gasulla, D Prieto, EG Redruello, CG Sagastume, AG Garnacho-Montero, J Castillo, MLG Goma, G Gomez, JM Casal, VG Gomez, S Gonzalez, CG de Gonzalo-Calvo, D Gonzalez, J Gordo, F Gracia, MP Gumucio-Sanguino, VD Herraiz, A Herran-Monge, R Huerta, A Ibarz, M Iglesias, S Janer, MT Jimenez, G Garcia, RNJ Diaz, MJ Kiarostami, K Alvarez, JI Leon, M Lopez-Gavin, A Lago, AL Messa, JL Lopez-Ramos, E Loza-Vazquez, A Guerrero, DM Herrera, NM Mendiluce, RM Mantellini, CL Naya, GM Marcos, P Marin-Corral, J Peis, EM Vicente, PM Martinez, M Fernandez, CEM de la Gandara, AM Juan, MDM Palacios, BM Varela, IM Jimenez, JFM Masclans, JR Maseda, E Fernandez, EMM Miralbes, M Monclou, J Montejo-Gonzalez, JC Montserrat, N Aznar, MM Morales, D Cano, SGM Rodriguez, DM Munoz-Bermudez, R Albaiceta, GM Nicolas, JM Nieto, MT Bou, RN Salinas, RN Ocon, M Ortega, A Ossa, S Pagliarani, P Parrilla, F Pedregosa-Diaz, J Penasco, Y Penuelas, O Bastida, LP Perez, P Perez-Garcia, F Planelles, GP Rubio, EP Laguna, DP Pinol-Tena, A Prados, J Pujol, A Pozo, JC Coll, NR Sanchez-Giron, GR Riera, J Ricart, P Roche-Campo, F Rodriguez, A Rodriguez, L de Castro, FR Rodriguez, S Ruiz, CR Rubio, J Lopez, AR Ruiz-Garcia, AL Miralles, MR Murua, PR Paz, ES Sagredo, V Degracia, AS Salvador-Adell, I Sanchez, A Sanchez-Miralles, A Chinesta, SS Santacoloma, B Sanchez, M Sarinena, MT Pensado, MS Serra, L Serra-Fortuny, M Lazaro, AS Servia, L Socias, L Soliva, L Sole-Violan, J Sipmann, FS Speziale, C Lomas, LT Tormos, A de la Torre, MD Torres, G Torres, M Trefler, S Trenado, J Trujillano, J Ubeda, A Urrelo-Cerron, L Val, E Valledor, M Ruiz, LV Vallverdu, M Martin-montalvo, MV Adrio, SV Vazquez, N Vengoechea, J Vidal, P Vila-Vilardel, C Vilanova, J Warrington, TV Yang, H Yang, ML Zapatero, A |
| author |
Ceccato, A |
| author_facet |
Ceccato, A Forne, C Bos, LD Camprubi-Rimblas, M Areny-Balaguero, A Campana-Duel, E Quero, S Roca, O De Gonzalo-Calvo, D Fernandez-Barat, L Motos, A Ferrer, R Lorente, JA Menendez, R Amaya-Villar, R Anon, JM Balan-Marino, A Blandino-Ortiz, A Boado, MV Garcia-Garmendia, JL Jorge-Garcia, RN de la Gandara, AM Martin-Delgado, MC Martinez-Varela, I Muniz-Albaiceta, G Pozo-Laderas, JC Sancho-Chinesta, S Suarez-Sipmann, F Tamayo-Lomas, L Trenado, J Valdivia, LJ Bermejo, J Gonzalez, J Barbe, F Calfee, CS Artigas, A Torres, A Adell-Serrano, B Cabello, MA Aguilera, L Alcaraz-Serrano, V Aldecoa, C Alegre, C Almansa, R Alvarez, S Ruiz, AA Villar, RA Andrea, R Novo, MA Angel, J Arrieta, M Ayestaran, J Badia, JR Badia, M Pravia, OB Marino, AB Balsera, B Barbera, C Barberan, J Barbena, L Barbeta, E Bardi, T Segade, PB Barroso, M Garcia, JAB Bermejo-Martin, JF Betere, B Bigas, J Ortiz, AB Blancas, R Cortes, MLB Boado, M Saera, MB Bofill, N Vieiro, MTB Bueno, L Bustamante-Munguira, E Bustamante-Munguira, J Martinez, CD Caballero, J Hermoso, DC Fernandez, SC Carbajales, C Cano, I Canton-Bulnes, ML Carbonell, N Fernandez, PC Garcia, LC Carvalho, S Casacuberta-Barbera, N Castella, M Castellvi, A Castro, P Catalan-Gonzalez, M Avila, RC Cilloniz, C Clar, L Climent, C Codina, J Conde, P Contreras, S Martin, MC Sanchez, RD De Mendoza, D Diaz, E Diaz, Y Vilas, MDR Moreno, CD Dot, I Giraudo, PE Arijon, IE Estella, A Monjo, TF Fernandez, J Ferrando, C Figueras, A Forcadell-Ferreres, E Espina, LF Franco, N Franquesa, E Furro, A Gabarrus, A Galban, C Gallego, E Garcia, F Garcia, B Garmendia, JLG Garcia-Gasulla, D Prieto, EG Redruello, CG Sagastume, AG Garnacho-Montero, J Castillo, MLG Goma, G Gomez, JM Casal, VG Gomez, S Gonzalez, CG de Gonzalo-Calvo, D Gordo, F Gracia, MP Gumucio-Sanguino, VD Herraiz, A Herran-Monge, R Huerta, A Ibarz, M Iglesias, S Janer, MT Jimenez, G Garcia, RNJ Diaz, MJ Kiarostami, K Alvarez, JI Leon, M Lopez-Gavin, A Lago, AL Messa, JL Lopez-Ramos, E Loza-Vazquez, A Guerrero, DM Herrera, NM Mendiluce, RM Mantellini, CL Naya, GM Marcos, P Marin-Corral, J Peis, EM Vicente, PM Martinez, M Fernandez, CEM Juan, MDM Palacios, BM Varela, IM Jimenez, JFM Masclans, JR Maseda, E Fernandez, EMM Miralbes, M Monclou, J Montejo-Gonzalez, JC Montserrat, N Aznar, MM Morales, D Cano, SGM Rodriguez, DM Munoz-Bermudez, R Albaiceta, GM Nicolas, JM Nieto, MT Bou, RN Salinas, RN Ocon, M Ortega, A Ossa, S Pagliarani, P Parrilla, F Pedregosa-Diaz, J Penasco, Y Penuelas, O Bastida, LP Perez, P Perez-Garcia, F Planelles, GP Rubio, EP Laguna, DP Pinol-Tena, A Prados, J Pujol, A Pozo, JC Coll, NR Sanchez-Giron, GR Riera, J Ricart, P Roche-Campo, F Rodriguez, A Rodriguez, L de Castro, FR Rodriguez, S Ruiz, CR Rubio, J Lopez, AR Ruiz-Garcia, AL Miralles, MR Murua, PR Paz, ES Sagredo, V Degracia, AS Salvador-Adell, I Sanchez, A Sanchez-Miralles, A Chinesta, SS Santacoloma, B Sanchez, M Sarinena, MT Pensado, MS Serra, L Serra-Fortuny, M Lazaro, AS Servia, L Socias, L Soliva, L Sole-Violan, J Sipmann, FS Speziale, C Lomas, LT Tormos, A de la Torre, MD Torres, G Torres, M Trefler, S Trujillano, J Ubeda, A Urrelo-Cerron, L Val, E Valledor, M Ruiz, LV Vallverdu, M Martin-montalvo, MV Adrio, SV Vazquez, N Vengoechea, J Vidal, P Vila-Vilardel, C Vilanova, J Warrington, TV Yang, H Yang, ML Zapatero, A |
| author_role |
author |
| author2 |
Forne, C Bos, LD Camprubi-Rimblas, M Areny-Balaguero, A Campana-Duel, E Quero, S Roca, O De Gonzalo-Calvo, D Fernandez-Barat, L Motos, A Ferrer, R Lorente, JA Menendez, R Amaya-Villar, R Anon, JM Balan-Marino, A Blandino-Ortiz, A Boado, MV Garcia-Garmendia, JL Jorge-Garcia, RN de la Gandara, AM Martin-Delgado, MC Martinez-Varela, I Muniz-Albaiceta, G Pozo-Laderas, JC Sancho-Chinesta, S Suarez-Sipmann, F Tamayo-Lomas, L Trenado, J Valdivia, LJ Bermejo, J Gonzalez, J Barbe, F Calfee, CS Artigas, A Torres, A Adell-Serrano, B Cabello, MA Aguilera, L Alcaraz-Serrano, V Aldecoa, C Alegre, C Almansa, R Alvarez, S Ruiz, AA Villar, RA Andrea, R Novo, MA Angel, J Arrieta, M Ayestaran, J Badia, JR Badia, M Pravia, OB Marino, AB Balsera, B Barbera, C Barberan, J Barbena, L Barbeta, E Bardi, T Segade, PB Barroso, M Garcia, JAB Bermejo-Martin, JF Betere, B Bigas, J Ortiz, AB Blancas, R Cortes, MLB Boado, M Saera, MB Bofill, N Vieiro, MTB Bueno, L Bustamante-Munguira, E Bustamante-Munguira, J Martinez, CD Caballero, J Hermoso, DC Fernandez, SC Carbajales, C Cano, I Canton-Bulnes, ML Carbonell, N Fernandez, PC Garcia, LC Carvalho, S Casacuberta-Barbera, N Castella, M Castellvi, A Castro, P Catalan-Gonzalez, M Avila, RC Cilloniz, C Clar, L Climent, C Codina, J Conde, P Contreras, S Martin, MC Sanchez, RD De Mendoza, D Diaz, E Diaz, Y Vilas, MDR Moreno, CD Dot, I Giraudo, PE Arijon, IE Estella, A Monjo, TF Fernandez, J Ferrando, C Figueras, A Forcadell-Ferreres, E Espina, LF Franco, N Franquesa, E Furro, A Gabarrus, A Galban, C Gallego, E Garcia, F Garcia, B Garmendia, JLG Garcia-Gasulla, D Prieto, EG Redruello, CG Sagastume, AG Garnacho-Montero, J Castillo, MLG Goma, G Gomez, JM Casal, VG Gomez, S Gonzalez, CG de Gonzalo-Calvo, D Gordo, F Gracia, MP Gumucio-Sanguino, VD Herraiz, A Herran-Monge, R Huerta, A Ibarz, M Iglesias, S Janer, MT Jimenez, G Garcia, RNJ Diaz, MJ Kiarostami, K Alvarez, JI Leon, M Lopez-Gavin, A Lago, AL Messa, JL Lopez-Ramos, E Loza-Vazquez, A Guerrero, DM Herrera, NM Mendiluce, RM Mantellini, CL Naya, GM Marcos, P Marin-Corral, J Peis, EM Vicente, PM Martinez, M Fernandez, CEM Juan, MDM Palacios, BM Varela, IM Jimenez, JFM Masclans, JR Maseda, E Fernandez, EMM Miralbes, M Monclou, J Montejo-Gonzalez, JC Montserrat, N Aznar, MM Morales, D Cano, SGM Rodriguez, DM Munoz-Bermudez, R Albaiceta, GM Nicolas, JM Nieto, MT Bou, RN Salinas, RN Ocon, M Ortega, A Ossa, S Pagliarani, P Parrilla, F Pedregosa-Diaz, J Penasco, Y Penuelas, O Bastida, LP Perez, P Perez-Garcia, F Planelles, GP Rubio, EP Laguna, DP Pinol-Tena, A Prados, J Pujol, A Pozo, JC Coll, NR Sanchez-Giron, GR Riera, J Ricart, P Roche-Campo, F Rodriguez, A Rodriguez, L de Castro, FR Rodriguez, S Ruiz, CR Rubio, J Lopez, AR Ruiz-Garcia, AL Miralles, MR Murua, PR Paz, ES Sagredo, V Degracia, AS Salvador-Adell, I Sanchez, A Sanchez-Miralles, A Chinesta, SS Santacoloma, B Sanchez, M Sarinena, MT Pensado, MS Serra, L Serra-Fortuny, M Lazaro, AS Servia, L Socias, L Soliva, L Sole-Violan, J Sipmann, FS Speziale, C Lomas, LT Tormos, A de la Torre, MD Torres, G Torres, M Trefler, S Trujillano, J Ubeda, A Urrelo-Cerron, L Val, E Valledor, M Ruiz, LV Vallverdu, M Martin-montalvo, MV Adrio, SV Vazquez, N Vengoechea, J Vidal, P Vila-Vilardel, C Vilanova, J Warrington, TV Yang, H Yang, ML Zapatero, A |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
ARDS Clustering Mortality Precision medicine |
| topic |
ARDS Clustering Mortality Precision medicine |
| description |
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. |
| publishDate |
2024 |
| dc.date.none.fl_str_mv |
2024 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
| status_str |
publishedVersion |
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https://i3pt.portalinvestigacion.com/publicaciones/5076 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85188329150&doi=10.1186%2fs13054-024-04876-5&partnerID=40&md5=936b0eafc71a903809927bd4ff59ba5d |
| url |
https://i3pt.portalinvestigacion.com/publicaciones/5076 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85188329150&doi=10.1186%2fs13054-024-04876-5&partnerID=40&md5=936b0eafc71a903809927bd4ff59ba5d |
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Inglés |
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Inglés |
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info:eu-repo/semantics/openAccess |
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openAccess |
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BMC |
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BMC |
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CRITICAL CARE ISSN: 13648535 ISSNe: 1466609X reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí instname:Institut d'Investigació i Innovació Parc Taulí (I3PT) |
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Institut d'Investigació i Innovació Parc Taulí (I3PT) |
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r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
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r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
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1869415970004533248 |
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Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID CohortCeccato, AForne, CBos, LDCamprubi-Rimblas, MAreny-Balaguero, ACampana-Duel, EQuero, SRoca, ODe Gonzalo-Calvo, DFernandez-Barat, LMotos, AFerrer, RLorente, JAMenendez, RAmaya-Villar, RAnon, JMBalan-Marino, ABlandino-Ortiz, ABoado, MVGarcia-Garmendia, JLJorge-Garcia, RNde la Gandara, AMMartin-Delgado, MCMartinez-Varela, IMuniz-Albaiceta, GPozo-Laderas, JCSancho-Chinesta, SSuarez-Sipmann, FTamayo-Lomas, LTrenado, JValdivia, LJBermejo, JGonzalez, JBarbe, FCalfee, CSArtigas, ATorres, AAdell-Serrano, BCabello, MAAguilera, LAlcaraz-Serrano, VAldecoa, CAlegre, CAlmansa, RAlvarez, SRuiz, AAVillar, RAAndrea, RNovo, MAAngel, JAnon, JMArrieta, MAyestaran, JBadia, JRBadia, MPravia, OBMarino, ABBalsera, BBarbera, CBarberan, JBarbena, LBarbeta, EBardi, TSegade, PBBarroso, MGarcia, JABBermejo-Martin, JFBetere, BBigas, JOrtiz, ABBlancas, RCortes, MLBBoado, MSaera, MBBofill, NVieiro, MTBBueno, LBustamante-Munguira, EBustamante-Munguira, JMartinez, CDCaballero, JHermoso, DCFernandez, SCCarbajales, CCano, ICanton-Bulnes, MLCarbonell, NFernandez, PCGarcia, LCCarvalho, SCasacuberta-Barbera, NCastella, MCastellvi, ACastro, PCatalan-Gonzalez, MAvila, RCCilloniz, CClar, LCliment, CCodina, JConde, PContreras, SMartin, MCSanchez, RDDe Mendoza, DDiaz, EDiaz, YVilas, MDRMoreno, CDDot, IGiraudo, PEArijon, IEEstella, AMonjo, TFFernandez, JFerrando, CFigueras, AForcadell-Ferreres, EEspina, LFFranco, NFranquesa, EFurro, AGabarrus, AGalban, CGallego, EGarcia, FGarcia, BGarmendia, JLGGarcia-Gasulla, DPrieto, EGRedruello, CGSagastume, AGGarnacho-Montero, JCastillo, MLGGoma, GGomez, JMCasal, VGGomez, SGonzalez, CGde Gonzalo-Calvo, DGonzalez, JGordo, FGracia, MPGumucio-Sanguino, VDHerraiz, AHerran-Monge, RHuerta, AIbarz, MIglesias, SJaner, MTJimenez, GGarcia, RNJDiaz, MJKiarostami, KAlvarez, JILeon, MLopez-Gavin, ALago, ALMessa, JLLopez-Ramos, ELoza-Vazquez, AGuerrero, DMHerrera, NMMendiluce, RMMantellini, CLNaya, GMMarcos, PMarin-Corral, JPeis, EMVicente, PMMartinez, MFernandez, CEMde la Gandara, AMJuan, MDMPalacios, BMVarela, IMJimenez, JFMMasclans, JRMaseda, EFernandez, EMMMiralbes, MMonclou, JMontejo-Gonzalez, JCMontserrat, NAznar, MMMorales, DCano, SGMRodriguez, DMMunoz-Bermudez, RAlbaiceta, GMNicolas, JMNieto, MTBou, RNSalinas, RNOcon, MOrtega, AOssa, SPagliarani, PParrilla, FPedregosa-Diaz, JPenasco, YPenuelas, OBastida, LPPerez, PPerez-Garcia, FPlanelles, GPRubio, EPLaguna, DPPinol-Tena, APrados, JPujol, APozo, JCColl, NRSanchez-Giron, GRRiera, JRicart, PRoche-Campo, FRodriguez, ARodriguez, Lde Castro, FRRodriguez, SRuiz, CRRubio, JLopez, ARRuiz-Garcia, ALMiralles, MRMurua, PRPaz, ESSagredo, VDegracia, ASSalvador-Adell, ISanchez, ASanchez-Miralles, AChinesta, SSSantacoloma, BSanchez, MSarinena, MTPensado, MSSerra, LSerra-Fortuny, MLazaro, ASServia, LSocias, LSoliva, LSole-Violan, JSipmann, FSSpeziale, CLomas, LTTormos, Ade la Torre, MDTorres, GTorres, MTrefler, STrenado, JTrujillano, JUbeda, AUrrelo-Cerron, LVal, EValledor, MRuiz, LVVallverdu, MMartin-montalvo, MVAdrio, SVVazquez, NVengoechea, JVidal, PVila-Vilardel, CVilanova, JWarrington, TVYang, HYang, MLZapatero, AARDSClusteringMortalityPrecision medicineBackground 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.BMC2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/5076https://www.scopus.com/inward/record.uri?eid=2-s2.0-85188329150&doi=10.1186%2fs13054-024-04876-5&partnerID=40&md5=936b0eafc71a903809927bd4ff59ba5dCRITICAL CAREISSN: 13648535ISSNe: 1466609Xreponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p50762026-06-21T15:30:37Z |
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