Validating the genomic signature of pediatric septic shock datingforchristians info
To derive the risk stratification tool, biomarkers were measured in serum samples from 220 unselected children with septic shock, obtained during the first 24 hours of admission to the intensive care unit.
Classification and Regression Tree (CART) analysis was used to generate a decision tree to predict 28-day all-cause mortality based on both biomarkers and clinical variables.
Patients with a PICU LOS greater than 28 days were classified as having zero PICU-free days.
The primary outcome variable was all-cause 28-day mortality.
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It has been proposed that our inability to manage this heterogeneity is a major challenge for effective and rational clinical trials, and that a robust risk stratification tool could overcome this challenge .The data collection protocol was identical for both the derivation and test cohorts, and has been described in detail .PICU-free days were calculated by subtracting the actual PICU length of stay (LOS) from a theoretical maximum PICU LOS of 28 days.For clinical trials, individual patient management, and quality improvement efforts, it is unclear which patients are least likely to survive and thus benefit from alternative treatment approaches.A robust risk stratification tool would greatly aid decision-making.