Respiratory failure & ventilation
Inflammatory subphenotypes previously identified in ARDS are associated with mortality at intensive care unit discharge: a secondary analysis of a prospective observational study
Authors' conclusion
Patients assigned to the hyperinflammatory subphenotype at ICU discharge showed significantly stronger anomalies in coagulation activation, endothelial cell activation and inflammation pathways implicated in the pathogenesis of critical disease and increased mortality until one-year follow up.
Study context
- Population
- Intensive care unit (ICU)-survivors discharged alive from two Dutch ICUs, 2011–2014, with plasma biomarkers availableof 8332 in original cohort
- Participants
- 1,483 participants
- Comparison
- Hyperinflammatory vs Hypoinflammatory
- Hyperinflammatoryn = 86
- Hypoinflammatoryn = 1,397reference
- Primary endpoint
- Mortality after ICU discharge
- Follow-up
- 30 days and one year
Methodological detailstwo Dutch ICUs, sensitivity analysis by latent class analysis
- Two Dutch ICUs
- Sensitivity analysis by latent class analysis
Primary result
As reported in the abstract
Mortality
Mortality
One-year mortality
P < 0.001
- Hyperinflammatory vs Hypoinflammatory: P = 0.005 — 30-day mortality
Further findings
| Outcome | Hyperinflammatory | Hypoinflammatory | P value |
|---|---|---|---|
| SOFA score at ICU discharge | 7 (IQR 5–9) | 4 (IQR 2–6) | P < 0.001 |
Latent class analysis (sensitivity analysis)
- Latent class analysis (LCA) deemed 2 subphenotypes most suitable; class 1 had significantly higher mortality than class 2; hyperinflammatory patients mainly in class 1
Original publication
Inflammatory subphenotypes previously identified in ARDS are associated with mortality at intensive care unit discharge: a secondary analysis of a prospective observational study. Crit Care. Published 7 May 2024. doi:10.
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