Table 1.
Demographics, patient characteristics, and clinical outcomes among pediatric septic shock latent profile phenotypes in the derivation and validation sets
| Derivation set (n = 646) | p value | Validation set (n = 425) | p value | |||
|---|---|---|---|---|---|---|
| Phenotype 1 (n = 126) | Phenotype 2 (n = 520) | Phenotype 1 (n = 71) | Phenotype 2 (n = 354) | |||
| Age (years) | 4.7 (1.3, 13.7) | 5.4 (1.8, 10.8) | 0.698 | 6.2 (1.8, 14.0) | 5.5 (1.8, 10.4) | 0.480 |
| Sex (female) | 57 (45.2%) | 246 (47.3%) | 0.676 | 39 (54.9%) | 174 (49.2%) | 0.374 |
| Race | 0.924 | 0.439 | ||||
| White or Caucasian | 89 (70.7%) | 376 (72.3%) | 55 (77.4%) | 263 (74.3%) | ||
| Black or African American | 16 (12.7%) | 64 (12.3%) | 6 (8.4%) | 49 (13.8%) | ||
| Other | 21 (16.7%) | 80 (15.4%) | 10 (14.1%) | 42 (11.9%) | ||
| Ethnicity | 0.214 | 0.063 | ||||
| Hispanic or Latino | 12 (9.5%) | 71 (13.6%) | 3 (4.2%) | 41 (11.6%) | ||
| Non-Hispanic | 114 (90.5%) | 449 (86.4%) | 68 (95.7%) | 313 (88.4%) | ||
| Culture | ||||||
| Any positive culture | 71 (56.4%) | 309 (59.4%) | 0.529 | 44 (61.9%) | 198 (55.9%) | 0.348 |
| Pulmonary | 23 (18.2%) | 133 (25.6%) | 13 (18.3%) | 68 (19.2%) | ||
| Extra-pulmonary | 48 (38.1%) | 175 (33.6%) | 31 (43.7%) | 130 36.7%) | ||
| Positive blood culture | 33 (26.2%) | 100 (19.2%) | 0.083 | 24 (33.8%) | 73 (20.6%) | 0.016 |
| Pathogen type | 0.577 | 0.467 | ||||
| Gram positive | 26 (36.6%) | 121 (39.2%) | 18 (40.9%) | 78 (39.4%) | ||
| Gram negative | 28 (39.4%) | 122 (39.4%) | 17 (38.6%) | 88 (44.4%) | ||
| Viral | 7 (9.8%) | 38 (12.3%) | 3 (6.8%) | 16 (8.1%) | ||
| Fungal | 7 (9.8%) | 15 (4.8%) | 4 (9.0%) | 6 (13.6%) | ||
| Mixed | 3 (4.2%) | 13 (4.2%) | 2 (4.5%) | 8 (4.1%) | ||
| Comorbidity | ||||||
| Heart disease | 9 (7.1%) | 35 (6.7%) | 0.869 | 4 (5.6%) | 24 (6.8%) | 0.722 |
| Lung disease | 12 (9.5%) | 50 (9.6%) | 0.975 | 7 (9.8%) | 22 (6.2%) | 0.281 |
| Neurologic disease | 10 (7.9%) | 107 (20.6%) | 0.001 | 9 (12.7%) | 67 (18.9%) | 0.194 |
| Kidney disease | 19 (15.1%) | 13 (2.5%) | 0.001 | 5 (7.0%) | 10 (2.8%) | 0.079 |
| Liver disease | 10 (7.9%) | 25 (4.8%) | 0.164 | 12 (16.9%) | 28 (7.9%) | 0.018 |
| Solid organ transplant | 5 (4.0%) | 13 (2.5%) | 0.369 | 4 (5.6%) | 16 (4.5%) | 0.686 |
| Oncologic disease | 26 (20.6%) | 56 (10.8%) | 0.003 | 11 (15.5%) | 42 (11.9%) | 0.398 |
| Bone marrow transplant | 17 (13.5%) | 22 (4.3%) | < 0.001 | 9 (12.8%) | 29 (8.2%) | 0.227 |
| PRISM III | 16 (9, 24) | 11 (6, 16) | < 0.001 | 16 (11, 23) | 10 (6, 15) | < 0.001 |
| Day 1 VIS | 30 (10, 100) | 15 (7, 40) | < 0.001 | 40 (13, 150) | 16 (8, 31) | < 0.001 |
| Day 1 P/F < 250 | 31 (24.6%) | 118 (22.7%) | 0.648 | 23 (32.4%) | 69 (19.5%) | < 0.016 |
| PICU LOS | 7 (2, 15) | 6 (2, 12) | 0.673 | 7 (2, 14) | 5 (2, 11) | 0.815 |
| PICU Free days | 22 (12, 26) | 22 (16, 26) | 0.668 | 21 (14, 26) | 23 (17, 26) | 0.804 |
| Hospital LOS | 14 (5, 28) | 13 (7, 27) | 0.955 | 15 (3, 28) | 14 (7, 26) | 0.441 |
| 7-day mortality | 31 (24.6%) | 27 (5.2%) | < 0.001 | 20 (28.2%) | 19 (5.4%) | < 0.001 |
| 28-day mortality | 41 (32.5%) | 46 (8.9%) | < 0.001 | 25 (35.2%) | 30 (8.5%) | < 0.001 |
| Complicated course | 75 (59.5%) | 138 (26.5%) | < 0.001 | 48 (67.6%) | 96 (27.1%) | < 0.001 |
| Cardiac arrest | 67 (53.2%) | 76 (14.6%) | < 0.001 | 38 (53.5%) | 55 (15.5%) | < 0.001 |
| Day 7 Cardiovascular dysfunction | 54 (42.8%) | 85 (16.4%) | < 0.001 | 36 (50.7%) | 71 (20.1%) | < 0.001 |
| Day 7 Respiratory Dysfunction | 72 (57.2%) | 170 (32.7%) | < 0.001 | 46 (64.8%) | 120 (33.9%) | < 0.001 |
| Day 7 Kidney Dysfunction | 64 (50.8%) | 104 (20.0%) | < 0.001 | 42 (59.2%) | 68 (19.2%) | < 0.001 |
| Day 7 Neuro Dysfunction | 27 (21.4%) | 24 (4.6%) | < 0.001 | 19 (26.8%) | 19 (5.4%) | < 0.001 |
| Day 7 Hematologic Dysfunction | 59 (46.8%) | 79 (15.2%) | < 0.001 | 36 (50.7%) | 48 (13.6% 0 | < 0.001 |
| Day 7 Hepatic Dysfunction | 50 (39.7%) | 57 (11.0%) | < 0.001 | 34 (47.9%) | 31 (8.8%) | < 0.001 |
| Day 7 Vasoactive support† | 28/70 (40.0%) | 55/278 (19.7%) | < 0.001 | 15/39 (38.4%) | 40/173 (23.1%) | < 0.001 |
| Day 7 Mechanical ventilation† | 51/70 (72.8%) | 164/278 (58.9%) | 0.033 | 30/39 (76.9%) | 101/173 (58.3%) | 0.031 |
| Day 7 CRRT† | 27/70 (38.6%) | 22/278 (7.9%) | < 0.001 | 10/39 (25.6%) | 12/173 (6.9%) | < 0.001 |
| Day 1–7% positive fluid balance | 6.6 (1.9, 16.6%) | 4.9 (0.0, 11.7) | 0.016 | 8.3 (1.7, 17.8) | 4.9 (0.7, 11.6) | 0.008 |
| Any ECMO | 2 (1.6%) | 1 (0.2%) | 0.039 | 1 (1.4%) | 1 (0.3%) | 0.345 |
| Corticosteroids | 82 (65.1%) | 279 (53.7%) | 0.020 | 53 (74.7%) | 187 (52.8%) | < 0.001 |
PRISM III, Pediatric risk of mortality score-III; VIS, vasoactive inotropic score; P/F, PaO2/FiO2 ratio; LOS, length of stay; CRRT, Continuous renal replacement therapy; ECMO: Extracorporeal membrane oxygenation. ✝Indicates data only among patients alive and remaining in the PICU on Day 7 after enrollment