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Identification of Distinct Clinical Phenotypes of Heterogeneous Mechanically Ventilated ICU Patients Using Cluster Analysis

This retrospective study aimed to derive the clinical phenotypes of ventilated ICU patients to predict the outcomes on the first day of ventilation. Clinical phenotypes were derived from the eICU Collaborative Research Database (eICU) cohort via cluster analysis and were validated in the Medical Inf...

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Autores principales: Chen, Xuanhui, Li, Jiaxin, Liu, Guangjian, Chen, Xiujuan, Huang, Shuai, Li, Huixian, Liu, Siyi, Li, Dantong, Yang, Huan, Zheng, Haiqing, Hu, Lianting, Kong, Lingcong, Liu, Huazhang, Bellou, Abdelouahab, Lei, Liming, Liang, Huiying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962046/
https://www.ncbi.nlm.nih.gov/pubmed/36836034
http://dx.doi.org/10.3390/jcm12041499
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author Chen, Xuanhui
Li, Jiaxin
Liu, Guangjian
Chen, Xiujuan
Huang, Shuai
Li, Huixian
Liu, Siyi
Li, Dantong
Yang, Huan
Zheng, Haiqing
Hu, Lianting
Kong, Lingcong
Liu, Huazhang
Bellou, Abdelouahab
Lei, Liming
Liang, Huiying
author_facet Chen, Xuanhui
Li, Jiaxin
Liu, Guangjian
Chen, Xiujuan
Huang, Shuai
Li, Huixian
Liu, Siyi
Li, Dantong
Yang, Huan
Zheng, Haiqing
Hu, Lianting
Kong, Lingcong
Liu, Huazhang
Bellou, Abdelouahab
Lei, Liming
Liang, Huiying
author_sort Chen, Xuanhui
collection PubMed
description This retrospective study aimed to derive the clinical phenotypes of ventilated ICU patients to predict the outcomes on the first day of ventilation. Clinical phenotypes were derived from the eICU Collaborative Research Database (eICU) cohort via cluster analysis and were validated in the Medical Information Mart for Intensive Care (MIMIC-IV) cohort. Four clinical phenotypes were identified and compared in the eICU cohort (n = 15,256). Phenotype A (n = 3112) was associated with respiratory disease, had the lowest 28-day mortality (16%), and had a high extubation success rate (~80%). Phenotype B (n = 3335) was correlated with cardiovascular disease, had the second-highest 28-day mortality (28%), and had the lowest extubation success rate (69%). Phenotype C (n = 3868) was correlated with renal dysfunction, had the highest 28-day mortality (28%), and had the second-lowest extubation success rate (74%). Phenotype D (n = 4941) was associated with neurological and traumatic diseases, had the second-lowest 28-day mortality (22%), and had the highest extubation success rate (>80%). These findings were validated in the validation cohort (n = 10,813). Additionally, these phenotypes responded differently to ventilation strategies in terms of duration of treatment, but had no difference in mortality. The four clinical phenotypes unveiled the heterogeneity of ICU patients and helped to predict the 28-day mortality and the extubation success rate.
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spelling pubmed-99620462023-02-26 Identification of Distinct Clinical Phenotypes of Heterogeneous Mechanically Ventilated ICU Patients Using Cluster Analysis Chen, Xuanhui Li, Jiaxin Liu, Guangjian Chen, Xiujuan Huang, Shuai Li, Huixian Liu, Siyi Li, Dantong Yang, Huan Zheng, Haiqing Hu, Lianting Kong, Lingcong Liu, Huazhang Bellou, Abdelouahab Lei, Liming Liang, Huiying J Clin Med Article This retrospective study aimed to derive the clinical phenotypes of ventilated ICU patients to predict the outcomes on the first day of ventilation. Clinical phenotypes were derived from the eICU Collaborative Research Database (eICU) cohort via cluster analysis and were validated in the Medical Information Mart for Intensive Care (MIMIC-IV) cohort. Four clinical phenotypes were identified and compared in the eICU cohort (n = 15,256). Phenotype A (n = 3112) was associated with respiratory disease, had the lowest 28-day mortality (16%), and had a high extubation success rate (~80%). Phenotype B (n = 3335) was correlated with cardiovascular disease, had the second-highest 28-day mortality (28%), and had the lowest extubation success rate (69%). Phenotype C (n = 3868) was correlated with renal dysfunction, had the highest 28-day mortality (28%), and had the second-lowest extubation success rate (74%). Phenotype D (n = 4941) was associated with neurological and traumatic diseases, had the second-lowest 28-day mortality (22%), and had the highest extubation success rate (>80%). These findings were validated in the validation cohort (n = 10,813). Additionally, these phenotypes responded differently to ventilation strategies in terms of duration of treatment, but had no difference in mortality. The four clinical phenotypes unveiled the heterogeneity of ICU patients and helped to predict the 28-day mortality and the extubation success rate. MDPI 2023-02-14 /pmc/articles/PMC9962046/ /pubmed/36836034 http://dx.doi.org/10.3390/jcm12041499 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chen, Xuanhui
Li, Jiaxin
Liu, Guangjian
Chen, Xiujuan
Huang, Shuai
Li, Huixian
Liu, Siyi
Li, Dantong
Yang, Huan
Zheng, Haiqing
Hu, Lianting
Kong, Lingcong
Liu, Huazhang
Bellou, Abdelouahab
Lei, Liming
Liang, Huiying
Identification of Distinct Clinical Phenotypes of Heterogeneous Mechanically Ventilated ICU Patients Using Cluster Analysis
title Identification of Distinct Clinical Phenotypes of Heterogeneous Mechanically Ventilated ICU Patients Using Cluster Analysis
title_full Identification of Distinct Clinical Phenotypes of Heterogeneous Mechanically Ventilated ICU Patients Using Cluster Analysis
title_fullStr Identification of Distinct Clinical Phenotypes of Heterogeneous Mechanically Ventilated ICU Patients Using Cluster Analysis
title_full_unstemmed Identification of Distinct Clinical Phenotypes of Heterogeneous Mechanically Ventilated ICU Patients Using Cluster Analysis
title_short Identification of Distinct Clinical Phenotypes of Heterogeneous Mechanically Ventilated ICU Patients Using Cluster Analysis
title_sort identification of distinct clinical phenotypes of heterogeneous mechanically ventilated icu patients using cluster analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962046/
https://www.ncbi.nlm.nih.gov/pubmed/36836034
http://dx.doi.org/10.3390/jcm12041499
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