دورية أكاديمية
Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock
| العنوان: | Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock |
|---|---|
| المؤلفون: | Sanchez-Pinto, L Nelson, Bennett, Tellen D, DeWitt, Peter E, Russell, Seth, Rebull, Margaret N, Martin, Blake, Akech, Samuel, Albers, David J, Alpern, Elizabeth R, Balamuth, Fran, Bembea, Melania, Chisti, Mohammod Jobayer, Evans, Idris, Horvat, Christopher M, Jaramillo-Bustamante, Juan Camilo, Kissoon, Niranjan, Menon, Kusum, Scott, Halden F, Weiss, Scott L, Wiens, Matthew O, Zimmerman, Jerry J, Argent, Andrew C, Sorce, Lauren R, Schlapbach, Luregn J, Watson, R Scott, Society of Critical Care Medicine Pediatric Sepsis Definition Ta, Biban, Paolo, Carrol, Enitan, Chiotos, Kathleen, Flauzino De Oliveira, Claudio, Hall, Mark W, Inwald, David, Ishimine, Paul, Levin, Michael, Lodha, Rakesh, Nadel, Simon, Nakagawa, Satoshi, Peters, Mark J, Randolph, Adrienne G, Ranjit, Suchitra, Souza, Daniela Carla, Tissieres, Pierre, Wynn, James L |
| المصدر: | JAMA: Journal of the American Medical Association (2024) (In press). |
| بيانات النشر: | American Medical Association (AMA) |
| سنة النشر: | 2024 |
| المجموعة: | University College London: UCL Discovery |
| مصطلحات موضوعية: | Society of Critical Care Medicine Pediatric Sepsis Definition Task Force |
| الوصف: | IMPORTANCE: The Society of Critical Care Medicine Pediatric Sepsis Definition Task Force sought to develop and validate new clinical criteria for pediatric sepsis and septic shock using measures of organ dysfunction through a data-driven approach. OBJECTIVE: To derive and validate novel criteria for pediatric sepsis and septic shock across differently resourced settings. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, international, retrospective cohort study in 10 health systems in the US, Colombia, Bangladesh, China, and Kenya, 3 of which were used as external validation sites. Data were collected from emergency and inpatient encounters for children (aged <18 years) from 2010 to 2019: 3 049 699 in the development (including derivation and internal validation) set and 581 317 in the external validation set. EXPOSURE: Stacked regression models to predict mortality in children with suspected infection were derived and validated using the best-performing organ dysfunction subscores from 8 existing scores. The final model was then translated into an integer-based score used to establish binary criteria for sepsis and septic shock. MAIN OUTCOMES AND MEASURES: The primary outcome for all analyses was in-hospital mortality. Model- and integer-based score performance measures included the area under the precision recall curve (AUPRC; primary) and area under the receiver operating characteristic curve (AUROC; secondary). For binary criteria, primary performance measures were positive predictive value and sensitivity. RESULTS: Among the 172 984 children with suspected infection in the first 24 hours (development set; 1.2% mortality), a 4-organ-system model performed best. The integer version of that model, the Phoenix Sepsis Score, had AUPRCs of 0.23 to 0.38 (95% CI range, 0.20-0.39) and AUROCs of 0.71 to 0.92 (95% CI range, 0.70-0.92) to predict mortality in the validation sets. Using a Phoenix Sepsis Score of 2 points or higher in children with suspected infection as criteria for sepsis and sepsis plus 1 or more ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| العلاقة: | https://discovery.ucl.ac.uk/id/eprint/10186275/1/Peters_Data_Manuscript_R2_clean_Word_submitted.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10186275Test/ |
| الإتاحة: | https://discovery.ucl.ac.uk/id/eprint/10186275/1/Peters_Data_Manuscript_R2_clean_Word_submitted.pdfTest https://discovery.ucl.ac.uk/id/eprint/10186275Test/ |
| حقوق: | open |
| رقم الانضمام: | edsbas.BC35C635 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |