Development and Application of an Early Prediction Model for Risk of Bloodstream Infection based on Real-world Study

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 3, 2025

Background Bloodstream Infection (BSI) is a severe systemic infectious disease that can lead to sepsis and Multiple Organ Dysfunction Syndrome (MODS), resulting in high mortality rates posing major public health burden globally. Early identification of BSI crucial for effective intervention, reducing mortality, improving patient outcomes. However, existing diagnostic methods are flawed by low specificity, long detection times demands on testing platforms. The development artificial intelligence provides new approach early identification. This study aims explore the optimal combination routine laboratory data clinical monitoring indicators, utilize machine learning algorithms construct an early, rapid, universally applicable risk prediction model, assist diagnosis practice. Methods Clinical 2582 suspected patients admitted Chongqing University Central Hospital, from January 1, 2021 December 31, 2023 were collected this study. divided into modeling dataset external validation based chronological order, while was further training set internal set. occurrence rate BSI, distribution pathogens, microbial primary reporting time analyzed within During feature selection stage, univariate regression ML applied. First, Univariate logistic used screen predictive factors BSI. Then, Boruta algorithm, Lasso regression, Recursive Feature Elimination with Cross-validation (RFE-CV) employed determine predictors predicting Based combination, six model. best model selected models’ performance, Shapley Additive Explanations (SHAP) method explain evaluate performance generalizability research findings ultimately applied Results incidence among inpatients at Hospital 12.91%. Following selection, 5 variables determined, including white blood cell count, standard bicarbonate, base excess extracellular fluid, interleukin-6, body temperature. models constructed using algorithms, XGBoost demonstrating achieving AUC value 0.782 0.776 made publicly available as online webpage tool use. Conclusions successfully identified features analyzing indicators hospitalized patients. set, learning-based constructed. capable rapid differentiation between non-BSI inclusion minimal enhances its applicability settings, particularly care level. To improve model’s real-world more convenient use, application could greatly efficiency patients’ mortality.

Language: Английский

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A systematic review on the safety and efficacy of metamizole sodium as a therapy for the treatment of fever in children and adults

Terapevticheskii arkhiv, Journal Year: 2025, Volume and Issue: 97(1), P. 71 - 79

Published: Feb. 20, 2025

Aim. To systematically analyze existing publications from available scientific databases (PubMed, Cochrane, eLibrary) for the period 2018 to 2023 on treatment of fever in children and adults with metamizole sodium (MS). Materials methods. A systematic review efficacy safety MS therapy compared non-steroidal anti-inflammatory drugs was conducted. Six randomized clinical trials involving 884 patients (101 783 children) were included analysis. Results. In all studies, has been demonstrated be effective reducing both when used short-term therapy. is superior paracetamol, ibuprofen, acetylsalicylic acid not inferior nimesulide propacetamol terms effectiveness body temperature between 1.5 6.0 hours after oral intake. It shown that a safer strategy other drugs, as it no clinically significant risks gastric mucosal irritation, development gastrointestinal bleeding erosions. established therapeutic doses do lead an increase blood pressure, some cases contribute hypotensive effect, especially adult comorbid arterial hypertension. Conclusion. adults.

Language: Английский

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Wearable 3D-Printed Microneedle Sensor for Intradermal Temperature Monitoring

ACS Sensors, Journal Year: 2025, Volume and Issue: unknown

Published: April 14, 2025

Accurate temperature monitoring plays a crucial role in understanding the physiological status of patients and early diagnosis diseases commonly associated with local global infections. Intradermal measurement is, principle, more precise than skin surface detection, as it prevents interference from environmental changes secretions. However, to date, reliable intradermal real-time continuous manner remains challenge. We propose herein high-resolution 3D printing fabricate mechanically robust biocompatible hollow microneedle, filled temperature-responsive conducting polymer (poly(3,4-ethylenedioxythiophene): polystyrenesulfonate, PEDOT:PSS) develop microneedle sensor (T-MN). The significance is 2-fold: rational design MNs high resolution micrometer domain implementation MN format for sensing. analytical performance developed T-MN vitro evaluated under mimicked conditions, demonstrating good sensitivity (-0.74%° C-1), (0.2 °C), repeatability (RSD = 2%), reproducibility reversibility, medium-term stability. On-body performed on six euthanized rats 80 min. results presented agreement those obtained using commercial optical probe, which was intradermally inserted into rat skin. reliability utilizing successfully demonstrated, noting its potential use patient near future but also compensation (bio)sensors that may need it.

Language: Английский

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Improved Sixty-Day Mortality in Candidemia with Antifungal Treatment Within 72 Hours of Fever Onset: A Single-Center Retrospective Study in Rural Japan

Infectious Disease Reports, Journal Year: 2025, Volume and Issue: 17(2), P. 36 - 36

Published: April 21, 2025

Introduction: Prognostic factor investigations for candidemia have been conducted in large-scale facilities, leading to significant evidence, including early administration of echinocandin antifungal agents and removal central venous catheters (CVCs). In departments that provide aggressive chemotherapy or transplantation, candidiasis markers are regularly evaluated, preemptive treatments may be initiated. However, resource-limited detection largely relies on vital signs like fever blood cultures. This study assessed whether evidence from facilities applies such settings. Additionally, while prior studies indicate treatment is based positive cultures, no established criteria exist as an indicator. Methods: analyzed cases cultures at Fukui General Hospital (2014–2024). Patients aged 18 older with least one culture Candida species clinical infection were included, contamination excluded. The patients categorized into survival death groups 60-day onset. variables collected included age, gender, duration admission onset, time onset collection initiation, within 72 h, serum albumin levels, history cancer, diabetes, empiric treatment, CVC insertion, insertion until use total parenteral nutrition, broad-spectrum antibiotic use, sequential organ failure assessment (SOFA) score. Fever was defined a body temperature 38.0 °C higher, guiding collection. Results: Of 30 cases, 29 analyzed. Survival significantly associated younger age (average 73.3 ± 13.3 vs. 83.1 9.1 years, p = 0.038) h (9 3, 0.025). marginal significance (8 13, 0.108). There difference the (in days) (median [IQR]: 15.5 [11.75–19.5] 30.0 [19.0–39.0], 0.027). Logistic regression identified (OR 0.065, 0.035) 21.8, 0.024) independent predictors mortality. Conclusions: Early mortality candidemia. importance reaffirmed even smaller facilities. impact cannot readily generalized due limited sample size. Further research needed clarify fever-based initiation survival.

Language: Английский

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Severe intensive care unit–acquired hypernatraemia: Prevalence, risk factors, trajectory, management, and outcome

Critical Care and Resuscitation, Journal Year: 2024, Volume and Issue: 26(4), P. 311 - 318

Published: Nov. 22, 2024

Language: Английский

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Thermoregulation and survival during sepsis: insights from the cecal ligation and puncture experimental model

Intensive Care Medicine Experimental, Journal Year: 2024, Volume and Issue: 12(1)

Published: Nov. 10, 2024

Sepsis remains a major global health concern due to its high prevalence and mortality. Changes in body temperature (Tb), such as hypothermia or fever, are diagnostic indicators play crucial role the pathophysiology of sepsis. This study aims characterize thermoregulatory mechanisms during sepsis using cecal ligation puncture (CLP) model explore how severity ambient (Ta) influence Tb regulation Rats were subjected mild severe by CLP while housed at thermoneutral (28 °C) subthermoneutral (22 Ta, their was monitored for 12 h. Blood hypothalamus collected cytokines prostaglandin E

Language: Английский

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How cold is too cold during maternal sepsis? Navigating between maternal hypothermia and fetal bradycardia

European Journal of Obstetrics & Gynecology and Reproductive Biology, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 1, 2024

Language: Английский

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Comprehensive risk factor-based nomogram for predicting one-year mortality in patients with sepsis-associated encephalopathy

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: Oct. 14, 2024

Sepsis-associated encephalopathy (SAE) is a frequent and severe complication in septic patients, characterized by diffuse brain dysfunction resulting from systemic inflammation. Accurate prediction of long-term mortality these patients critical for improving clinical outcomes guiding treatment strategies. We conducted retrospective cohort study using the MIMIC IV database to identify adult diagnosed with SAE. Patients were randomly divided into training set (70%) validation (30%). Least absolute shrinkage selection operator regression multivariate logistic employed significant predictors 1-year mortality, which then used develop prognostic nomogram. The model's discrimination, calibration, utility assessed area under receiver operating characteristic curve (AUC), calibration plots, decision analysis, respectively. A total 3,882 SAE included analysis. nomogram demonstrated strong predictive performance AUCs 0.881 (95% CI: 0.865, 0.896) 0.859 0.830, 0.888) set. Calibration plots indicated good agreement between predicted observed rates. analysis showed that provided greater net benefit across range threshold probabilities compared traditional scoring systems such as Glasgow Coma Scale Sequential Organ Failure Assessment. Our presents robust clinically applicable predicting patients. This tool offers superior existing severity has potential enhance decision-making patient management care settings.

Language: Английский

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Management of spontaneous septic hypothermia in intensive care. A national survey of French intensive care units

Frontiers in Medicine, Journal Year: 2024, Volume and Issue: 11

Published: June 6, 2024

The benefit of temperature control in sepsis or septic shock is still under debate the literature. We developed a national survey to assess current state knowledge and practical management spontaneous hypothermia French intensive care units. Out more 764 intensivists who were contacted, 436 responded survey. majority doctors (52.4%) considered be frequently encountered situation care, 62.1% interested this problem. Definition among was not consensual. More than half questioned (57.1%) stated that they did actively rewarm patients suffering from hypothermia.

Language: Английский

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Hypothermia and Influence of Rewarming Rates on Survival Among Patients Admitted to Intensive Care with Bloodstream Infection: A Multicenter Cohort Study

Therapeutic Hypothermia and Temperature Management, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 23, 2024

Although critically ill patients with bloodstream infections (BSIs) who present hypothermia are at the highest risk for death, it is not known how rewarming rates may influence outcomes. The objective of this study was to identify occurrence and determinants among admitted intensive care units (ICUs) BSI assess rate temperature correction 90-day all-cause case-fatality. A cohort 3951 ICU admissions associated assembled. lowest measured within first 24 hours admission identified, those were hypothermic (<36°C), [(time difference between subsequent ≥36°C) divided by severity (difference 36°C)] determined. Within ICU, 329 (8.4%) 897 (22.7%) subjects had measurements ranging <34.9°C 35-35.9°C, respectively. Patients lower temperatures more likely be tertiary ICUs, have comorbid illnesses, greater illness, a higher need organ-supportive therapies. case-fatality 22.9% overall 45.3%, 24.8%, 19.6% <35°C, ≥36°C, respectively (

Language: Английский

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