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Dynamic Transitions of Pediatric Sepsis: A Markov Chain Analysis

Pediatric sepsis is a heterogeneous disease with varying physiological dynamics associated with recovery, disability, and mortality. Using risk scores generated from a sepsis prediction model to define illness states, we used Markov chain modeling to describe disease dynamics over time by describing...

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Autores principales: Kausch, Sherry L., Lobo, Jennifer M., Spaeder, Michael C., Sullivan, Brynne, Keim-Malpass, Jessica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517521/
https://www.ncbi.nlm.nih.gov/pubmed/34660494
http://dx.doi.org/10.3389/fped.2021.743544
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author Kausch, Sherry L.
Lobo, Jennifer M.
Spaeder, Michael C.
Sullivan, Brynne
Keim-Malpass, Jessica
author_facet Kausch, Sherry L.
Lobo, Jennifer M.
Spaeder, Michael C.
Sullivan, Brynne
Keim-Malpass, Jessica
author_sort Kausch, Sherry L.
collection PubMed
description Pediatric sepsis is a heterogeneous disease with varying physiological dynamics associated with recovery, disability, and mortality. Using risk scores generated from a sepsis prediction model to define illness states, we used Markov chain modeling to describe disease dynamics over time by describing how children transition among illness states. We analyzed 18,666 illness state transitions over 157 pediatric intensive care unit admissions in the 3 days following blood cultures for suspected sepsis. We used Shannon entropy to quantify the differences in transition matrices stratified by clinical characteristics. The population-based transition matrix based on the sepsis illness severity scores in the days following a sepsis diagnosis can describe a sepsis illness trajectory. Using the entropy based on Markov chain transition matrices, we found a different structure of dynamic transitions based on ventilator use but not age group. Stochastic modeling of transitions in sepsis illness severity scores can be useful in describing the variation in transitions made by patient and clinical characteristics.
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spelling pubmed-85175212021-10-16 Dynamic Transitions of Pediatric Sepsis: A Markov Chain Analysis Kausch, Sherry L. Lobo, Jennifer M. Spaeder, Michael C. Sullivan, Brynne Keim-Malpass, Jessica Front Pediatr Pediatrics Pediatric sepsis is a heterogeneous disease with varying physiological dynamics associated with recovery, disability, and mortality. Using risk scores generated from a sepsis prediction model to define illness states, we used Markov chain modeling to describe disease dynamics over time by describing how children transition among illness states. We analyzed 18,666 illness state transitions over 157 pediatric intensive care unit admissions in the 3 days following blood cultures for suspected sepsis. We used Shannon entropy to quantify the differences in transition matrices stratified by clinical characteristics. The population-based transition matrix based on the sepsis illness severity scores in the days following a sepsis diagnosis can describe a sepsis illness trajectory. Using the entropy based on Markov chain transition matrices, we found a different structure of dynamic transitions based on ventilator use but not age group. Stochastic modeling of transitions in sepsis illness severity scores can be useful in describing the variation in transitions made by patient and clinical characteristics. Frontiers Media S.A. 2021-10-01 /pmc/articles/PMC8517521/ /pubmed/34660494 http://dx.doi.org/10.3389/fped.2021.743544 Text en Copyright © 2021 Kausch, Lobo, Spaeder, Sullivan and Keim-Malpass. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Kausch, Sherry L.
Lobo, Jennifer M.
Spaeder, Michael C.
Sullivan, Brynne
Keim-Malpass, Jessica
Dynamic Transitions of Pediatric Sepsis: A Markov Chain Analysis
title Dynamic Transitions of Pediatric Sepsis: A Markov Chain Analysis
title_full Dynamic Transitions of Pediatric Sepsis: A Markov Chain Analysis
title_fullStr Dynamic Transitions of Pediatric Sepsis: A Markov Chain Analysis
title_full_unstemmed Dynamic Transitions of Pediatric Sepsis: A Markov Chain Analysis
title_short Dynamic Transitions of Pediatric Sepsis: A Markov Chain Analysis
title_sort dynamic transitions of pediatric sepsis: a markov chain analysis
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517521/
https://www.ncbi.nlm.nih.gov/pubmed/34660494
http://dx.doi.org/10.3389/fped.2021.743544
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