Cargando…
The Impact of Positive Fluid Balance on Sepsis Subtypes: A Causal Inference Study
INTRODUCTION: Sepsis, the leading cause of death in hospitalized patients globally, was investigated in this study, examining the varying effects of positive fluid balance on sepsis subtypes through causal inference. METHODS: In this study, data from the eICU database were utilized, extracting 35 fe...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10564571/ https://www.ncbi.nlm.nih.gov/pubmed/37822416 http://dx.doi.org/10.1155/2023/2081588 |
_version_ | 1785118506501537792 |
---|---|
author | Patel, Sharad Green, Adam Wolfe, Yanika Felock, Gregory Epstein, Samantha Puri, Nitin |
author_facet | Patel, Sharad Green, Adam Wolfe, Yanika Felock, Gregory Epstein, Samantha Puri, Nitin |
author_sort | Patel, Sharad |
collection | PubMed |
description | INTRODUCTION: Sepsis, the leading cause of death in hospitalized patients globally, was investigated in this study, examining the varying effects of positive fluid balance on sepsis subtypes through causal inference. METHODS: In this study, data from the eICU database were utilized, extracting 35 features from sepsis patients. Fluid balance during ICU stay was the treatment, and ICU mortality was the primary outcome. Data preprocessing ensured linear assumptions for logistic regression. Binarized positive fluid balance with mortality was examined using DoWhy's logistic regression, while continuous data were analyzed with random forest T-learner. ATE served as the primary metric. RESULTS: Results revealed that septic patients with higher fluid balance had worse mortality outcomes, with an ATE of 0.042 (95% CI: (0.034, 0.047)) using logistic regression and an ATE of 0.0340 (95% CI: (0.028–0.040)) using T-learner. In the pulmonary sepsis subtype, higher mortality was associated with increased fluid balance, showing an ATE of 0.047 (95% CI: (0.037, 0.055)) using logistic regression and an ATE of 0.28 (95% CI: (0.22, 0.34)) with T-learner. Conversely, urinary sepsis patients had improved mortality with higher fluid balance, presenting an ATE of −0.135 (95% CI: (−0.024, −0.0035)) using logistic regression and an ATE of −0.28 (95% CI: (−0.34, −0.22)) with T-learner. CONCLUSION: Our research implies that fluid balance impact on ICU mortality differs among sepsis subtypes. Positive fluid balance raises mortality in sepsis and pulmonary sepsis but may protect against urinary sepsis. Further trials are needed to confirm these findings. |
format | Online Article Text |
id | pubmed-10564571 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-105645712023-10-11 The Impact of Positive Fluid Balance on Sepsis Subtypes: A Causal Inference Study Patel, Sharad Green, Adam Wolfe, Yanika Felock, Gregory Epstein, Samantha Puri, Nitin Crit Care Res Pract Research Article INTRODUCTION: Sepsis, the leading cause of death in hospitalized patients globally, was investigated in this study, examining the varying effects of positive fluid balance on sepsis subtypes through causal inference. METHODS: In this study, data from the eICU database were utilized, extracting 35 features from sepsis patients. Fluid balance during ICU stay was the treatment, and ICU mortality was the primary outcome. Data preprocessing ensured linear assumptions for logistic regression. Binarized positive fluid balance with mortality was examined using DoWhy's logistic regression, while continuous data were analyzed with random forest T-learner. ATE served as the primary metric. RESULTS: Results revealed that septic patients with higher fluid balance had worse mortality outcomes, with an ATE of 0.042 (95% CI: (0.034, 0.047)) using logistic regression and an ATE of 0.0340 (95% CI: (0.028–0.040)) using T-learner. In the pulmonary sepsis subtype, higher mortality was associated with increased fluid balance, showing an ATE of 0.047 (95% CI: (0.037, 0.055)) using logistic regression and an ATE of 0.28 (95% CI: (0.22, 0.34)) with T-learner. Conversely, urinary sepsis patients had improved mortality with higher fluid balance, presenting an ATE of −0.135 (95% CI: (−0.024, −0.0035)) using logistic regression and an ATE of −0.28 (95% CI: (−0.34, −0.22)) with T-learner. CONCLUSION: Our research implies that fluid balance impact on ICU mortality differs among sepsis subtypes. Positive fluid balance raises mortality in sepsis and pulmonary sepsis but may protect against urinary sepsis. Further trials are needed to confirm these findings. Hindawi 2023-10-03 /pmc/articles/PMC10564571/ /pubmed/37822416 http://dx.doi.org/10.1155/2023/2081588 Text en Copyright © 2023 Sharad Patel et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Patel, Sharad Green, Adam Wolfe, Yanika Felock, Gregory Epstein, Samantha Puri, Nitin The Impact of Positive Fluid Balance on Sepsis Subtypes: A Causal Inference Study |
title | The Impact of Positive Fluid Balance on Sepsis Subtypes: A Causal Inference Study |
title_full | The Impact of Positive Fluid Balance on Sepsis Subtypes: A Causal Inference Study |
title_fullStr | The Impact of Positive Fluid Balance on Sepsis Subtypes: A Causal Inference Study |
title_full_unstemmed | The Impact of Positive Fluid Balance on Sepsis Subtypes: A Causal Inference Study |
title_short | The Impact of Positive Fluid Balance on Sepsis Subtypes: A Causal Inference Study |
title_sort | impact of positive fluid balance on sepsis subtypes: a causal inference study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10564571/ https://www.ncbi.nlm.nih.gov/pubmed/37822416 http://dx.doi.org/10.1155/2023/2081588 |
work_keys_str_mv | AT patelsharad theimpactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT greenadam theimpactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT wolfeyanika theimpactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT felockgregory theimpactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT epsteinsamantha theimpactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT purinitin theimpactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT patelsharad impactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT greenadam impactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT wolfeyanika impactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT felockgregory impactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT epsteinsamantha impactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy AT purinitin impactofpositivefluidbalanceonsepsissubtypesacausalinferencestudy |