Individual-specific principal component analysis of circulating inflammatory mediators predicts early organ dysfunction in trauma patients
| Autor: | Ruben Zamora, Akram Zaaqoq, Timothy R. Billiar, Khalid Almahmoud, Yoram Vodovotz, Rami A. Namas, Othman Abdul-Malak, Jason L. Sperry, Ali Ghuma, Xiao-Guang Zhu, Qi Mi, Rajaie Namas |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male 0301 basic medicine Oncology medicine.medical_specialty Multiple Organ Failure Inflammation Wounds Nonpenetrating Critical Care and Intensive Care Medicine Article 03 medical and health sciences Injury Severity Score 0302 clinical medicine Internal medicine medicine Cluster Analysis Humans Survivors Multiple Organ Dysfunction Score Principal Component Analysis business.industry Organ dysfunction Accidents Traffic 030208 emergency & critical care medicine Length of Stay Middle Aged medicine.disease Respiration Artificial 030104 developmental biology Blunt trauma Immunology Principal component analysis Cohort Time course Cytokines Accidental Falls Female Inflammation Mediators medicine.symptom Multiple organ dysfunction syndrome business Biomarkers |
| Zdroj: | Journal of Critical Care. 36:146-153 |
| ISSN: | 0883-9441 |
| DOI: | 10.1016/j.jcrc.2016.07.002 |
| Popis: | Purpose We hypothesized that early inflammation can drive, or impact, later multiple organ dysfunction syndrome (MODS), that patient-specific principal component analysis (PCA) of circulating inflammatory mediators could reveal conserved dynamic responses which would not be apparent from the unprocessed data, and that this computational approach could segregate trauma patients with regard to subsequent MODS. Methods From a cohort of 472 blunt trauma survivors, 2 separate subcohorts of moderately/severely injured patients were studied. Multiple inflammatory mediators were assessed in serial blood samples in the first 24 hours postinjury. PCA of these time course data was used to derive patient-specific “inflammation barcodes,” followed by hierarchical clustering to define patient subgroups. To define the generalizability of this approach, 2 different but overlapping Luminex kits were used. Results PCA/hierarchical clustering of 24-hour Luminex data segregated the patients into 2 groups that differed significantly in their Marshall multiple organ dysfunction score on subsequent days, independently of the specific set of inflammatory mediators analyzed. Multiple inflammatory mediators and their dynamic networks were significantly different in the 2 groups in both patient cohorts, demonstrating that the groups were defined based on “core” early responses exhibit truly different dynamic inflammatory trajectories. Conclusion Identification of patient-specific “core responses” can lead to early segregation of diverse trauma patients with regard to later MODS. Hence, we suggest that a focus on dynamic inflammatory networks rather than individual biomarkers is warranted. |
| Databáze: | OpenAIRE |
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