Rapid and robust identification of sepsis using SeptiCyte RAPID in a heterogenous patient population
Year: 2024
Type: preprint
Abstract: Background/Objective SeptiCyte RAPID is a transcriptional host response assay that discriminates between sepsis and non-infectious systemic inflammation (SIRS) with a one-hour turnaround time. The overall performance of this test in a cohort of 419 patients has recently been described [Balk et al., J Clin Med 2024, 13, 1194]. In this study we present results from a detailed stratification analysis in which SeptiCyte RAPID performance was evaluated in the same cohort across patient groups and subgroups encompassing different demographics, comorbidities and disease, sources and types of pathogens, interventional treatments, and clinically defined phenotypes. The aims were to identify variables that might affect the ability of SeptiCyte RAPID to discriminate between sepsis and SIRS, and to determine if any patient subgroups appeared to present a diagnostic challenge for the test. Methods 1) Subgroup analysis, with subgroups defined by individual demographic or clinical variables, using conventional statistical comparison tests. 2) Principal component analysis and k-means clustering analysis, to investigate phenotypic subgroups defined by unique combinations of demographic and clinical variables. Results No significant differences in SeptiCyte RAPID performance were observed between most groups and subgroups. One notable exception involved an enhanced SeptiCyte RAPID performance for a phenotypic subgroup defined by a combination of clinical variables suggesting a septic shock response. Conclusions We conclude that for this patient cohort SeptiCyte RAPID performance was largely unaffected by key variables associated with heterogeneity in patients suspected of sepsis.
Source: medRxiv
Authors: Robert Balk, Annette M. Esper, Greg S. Martin, Russell R. Miller, Bert K. Lopansri, John P. Burke, Mitchell Levy, Richard E. Rothman, Franco R. D’Alessio, Venkataramana K. Sidhaye, Neil R. Aggarwal, Jared A. Greenberg, Mark Yoder, Gourang Patel, Emily Gilbert, Jorge P. Parada, Majid Afshar, Jordan A. Kempker, Tom van der Poll, Marcus J. Schultz, Brendon P. Scicluna, Peter M. C. Klein Klouwenberg, Janice Liebler, Emily Blodget, Santhi Kumar, Xue W. Mei, Krupa Navalkar, Thomas D. Yager, Dayle Sampson, James T. Kirk, Silvia Cermelli, Roy F. Davis, Richard B. Brandon
Institutions: Rush University Medical Center, Grady Memorial Hospital, Emory University, FirstHealth of the Carolinas, University of Utah, Intermountain Medical Center, Brown University, Johns Hopkins University, University of Miami, University of Colorado Anschutz, University of Colorado Denver, Loyola University Medical Center, University of Wisconsin–Madison, Amsterdam University Medical Centers, University of Amsterdam, University of Oxford, Medical University of Vienna, University of Malta, Mater Dei Hospital, University of Southern California, Keck Hospital of USC
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4401945876