A Transcriptomic Classifier Model Identifies High-Risk Endotypes in a Prospective Study of Sepsis in Uganda*
Authors' conclusion
Sepsis endotypes derived in HICs share biological and clinical features with those identified in sub-Saharan Africa, with major differences in host-pathogen profiles.
Study context
- Population
- Adults hospitalized with suspected sepsis at a public referral hospital in Uganda
- Participants
- 128 adults
- Exposure
- HIC-derived transcriptomic sepsis endotypes (SRS-1, SRS-2, SRS-3) assigned by 19-gene and 7-gene classifiers
- SRS-1n = 30
- SRS-2n = 92
- SRS-3n = 6
- Outcome
- Endotype assignment by 19-gene classifier
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
- Mortality · 30 days — SRS-1
- 48.1%
- Persons living with HIV in SRS-1
- 80.0% · 24 of 30
- Mortality among patients assigned to SRS-3 by 7-gene classifier · 30 days
- 15.1% · 8
- Mortality among patients assigned to SRS-3 by 7-gene classifier: 8/53
Persons living with HIV in SRS-1
- Predominantly persons living with HIV with advanced immunosuppression and frequent tuberculosis
Mortality · 30 days
- Differed significantly by endotype; highest in SRS-1
Agreement between 19-gene and 7-gene sepsis response signatures (SRS) assignments
- Poor agreement (Cohen's kappa)
- 0.11
Mortality among patients assigned to SRS-3 by 7-gene classifier · 30 days
- Patient stratification suboptimal with 7-gene classifier
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
A Transcriptomic Classifier Model Identifies High-Risk Endotypes in a Prospective Study of Sepsis in Uganda*. Crit Care Med. Published 7 August 2023. doi:10.
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