ArticlePloS one2014
Testing the prognostic accuracy of the updated pediatric sepsis biomarker risk model.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers.
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Who cites it
47 citing papers in PubMed.
- The Pediatric Sepsis Biomarker Risk Model (PERSEVERE) Biomarkers Predict Clinical Deterioration and Mortality in Immunocompromised Children Evaluated for Infection.Scientific reports · 2019Trial
- Development of a Prognosis Prediction Model for Pediatric Sepsis Based on the NLPR.Journal of inflammation research · 2024Article
- Biomarkers estimating baseline mortality risk for neonatal sepsis: nPERSEVERE: neonate-specific sepsis biomarker risk model.Pediatric research · 2023Article
- Biomarker-based risk model to predict persistent multiple organ dysfunctions after congenital heart surgery: a prospective observational cohort study.Critical care (London, England) · 2023Observational
- Understanding clinical and biological heterogeneity to advance precision medicine in paediatric acute respiratory distress syndrome.The Lancet. Respiratory medicine · 2023Review
- Biomarker-based risk model to predict persistent multiple organ dysfunctions after congenital heart surgery â€" A prospective observational cohort study.Research square · 2023Article
- Refining empiric subgroups of pediatric sepsis using machine-learning techniques on observational data.Frontiers in pediatrics · 2023Review
- Identification of a pediatric acute hypoxemic respiratory failure signature in peripheral blood leukocytes at 24 hours post-ICU admission with machine learning.Frontiers in pediatrics · 2023Article
- Presepsin: Hope in the Quest for the Holy Grail.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Pediatric sepsis biomarkers for prognostic and predictive enrichment.Pediatric research · 2022Review
- Endothelial Dysfunction and Neutrophil Degranulation as Central Events in Sepsis Physiopathology.International journal of molecular sciences · 2021Review
- Gene Expression Profiles in Children With Suspected Sepsis.Annals of emergency medicine · 2020Review
- Prognostic and predictive enrichment in sepsis.Nature reviews. Nephrology · 2020Review
- Prognostic models will be victims of their own success, unless….Journal of the American Medical Informatics Association : JAMIA · 2019Article
- Precision medicine in pediatric sepsis.Current opinion in pediatrics · 2019Review
- Sepsis Biomarkers.Journal of pediatric intensive care · 2019Review
- Adaptation of a Biomarker-Based Sepsis Mortality Risk Stratification Tool for Pediatric Acute Respiratory Distress Syndrome.Critical care medicine · 2018Observational
- Curcumin suppresses inflammatory cytokines and heat shock protein 70 release and improves metabolic parameters during experimental sepsis.Pharmaceutical biology · 2017Article
- Procalcitonin and Pancreatic Stone Protein Function as Biomarkers in Early Diagnosis of Pediatric Acute Osteomyelitis.Medical science monitor : international medical journal of experimental and clinical research · 2017Article
- Improved Risk Stratification in Pediatric Septic Shock Using Both Protein and mRNA Biomarkers. PERSEVERE-XP.American journal of respiratory and critical care medicine · 2017Observational
Corrections and comments
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Authors and funding
25 authors.
Funding
Abstract
backgroundWe previously derived and validated a risk model to estimate mortality probability in children with septic shock (PERSEVERE; PEdiatRic SEpsis biomarkEr Risk modEl). PERSEVERE uses five biomarkers and age to estimate mortality probability. After the initial derivation and validation of PERSEVERE, we combined the derivation and validation cohorts (n = 355) and updated PERSEVERE. An important step in the development of updated risk models is to test their accuracy using an independent test cohort.
objectiveTo test the prognostic accuracy of the updated version PERSEVERE in an independent test cohort.
methodsStudy subjects were recruited from multiple pediatric intensive care units in the United States. Biomarkers were measured in 182 pediatric subjects with septic shock using serum samples obtained during the first 24 hours of presentation. The accuracy of PERSEVERE 28-day mortality risk estimate was tested using diagnostic test statistics, and the net reclassification improvement (NRI) was used to test whether PERSEVERE adds information to a physiology-based scoring system.
resultsMortality in the test cohort was 13.2%. Using a risk cut-off of 2.5%, the sensitivity of PERSEVERE for mortality was 83% (95% CI 62-95), specificity was 75% (68-82), positive predictive value was 34% (22-47), and negative predictive value was 97% (91-99). The area under the receiver operating characteristic curve was 0.81 (0.70-0.92). The false positive subjects had a greater degree of organ failure burden and longer intensive care unit length of stay, compared to the true negative subjects. When adding PERSEVERE to a physiology-based scoring system, the net reclassification improvement was 0.91 (0.47-1.35; p<0.001).
conclusionsThe updated version of PERSEVERE estimates mortality probability reliably in a heterogeneous test cohort of children with septic shock and provides information over and above a physiology-based scoring system.
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