ArticleCritical care medicine2016
Combining Prognostic and Predictive Enrichment Strategies to Identify Children With Septic Shock Responsive to Corticosteroids.
Article in Critical care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers.
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Who cites it
64 citing papers in PubMed.
- Pediatric sepsis-associated acute kidney injury: leveraging pathophysiology for risk stratification and identification of treatable traits.Pediatric nephrology (Berlin, Germany) · 2026Review
- Whole blood transcriptomics reveals sepsis mortality-associated changes in neutrophil degranulation.American journal of respiratory cell and molecular biology · 2026Observational
- External Validation, Molecular Signatures, and Therapeutic Relevance of Pediatric Sepsis-Associated Acute Kidney Injury Subphenotypes.Critical care medicine · 2026Observational
- Predicting pulmonary hypertension in infants with bronchopulmonary dysplasia.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Data-driven spatial-temporal framework for exploring the heterogeneity and temporality of sepsis.Chinese medical journal · 2026Review
- Corticosteroids in sepsis.Journal of intensive medicine · 2025Review
- The utility of neonatal sequential organ failure assessment in mortality risk in all neonates with suspected late-onset infection.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Metabolomic and cytokine profiles of high-risk sepsis phenotypes in children.Scientific reports · 2025Article
- Potential biomarkers used for risk estimation of pediatric sepsis-associated organ dysfunction and immune dysregulation.Pediatric research · 2025Review
- Multicenter target trial emulation to evaluate corticosteroids for sepsis stratified by predicted organ dysfunction trajectory.Nature communications · 2025Article
- Catecholamines in sepsis: pharmacological insights and clinical applications-a narrative review.Journal of anesthesia, analgesia and critical care · 2025Review
- Development and validation of a machine-learning-based model for identification of genes associated with sepsis-associated acute kidney injury.Frontiers in genetics · 2025Article
- Identifying septic shock subgroups to tailor fluid strategies through multi-omics integration.Nature communications · 2024Article
- The times are changing: A primer on novel clinical trial designs and endpoints in critical care research.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2024Article
- Applying Artificial Intelligence in Pediatric Clinical Trials: Potential Impacts and Obstacles.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024Article
- Biological basis of critical illness subclasses: from the bedside to the bench and back again.Critical care (London, England) · 2024Review
- A proposed framework for advancing acute kidney injury risk stratification and diagnosis in children: a report from the 26th Acute Disease Quality Initiative (ADQI) conference.Pediatric nephrology (Berlin, Germany) · 2024Article
- Clinical practice of sepsis-induced immunosuppression: Current immunotherapy and future options.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2024Review
- Precision diagnostics in children.Cambridge prisms. Precision medicine · 2023Review
- The use of machine learning and artificial intelligence within pediatric critical care.Pediatric research · 2023Review
4 more citing papers are in PubMed but not listed here.
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Authors and funding
19 authors.
Funding
Abstract
objectivesPrognostic and predictive enrichment strategies are fundamental tools of precision medicine. Identifying children with septic shock who may benefit from corticosteroids remains a challenge. We combined prognostic and predictive strategies to identify a pediatric septic shock subgroup responsive to corticosteroids.
designWe conducted a secondary analysis of 288 previously published pediatric subjects with septic shock. For prognostic enrichment, each study subject was assigned a baseline mortality probability using the pediatric sepsis biomarker risk model. For predictive enrichment, each study subject was allocated to one of two septic shock endotypes, based on a 100-gene signature reflecting adaptive immunity and glucocorticoid receptor signaling. The primary study endpoint was complicated course, defined as the persistence of two or more organ failures at day 7 of septic shock or 28-day mortality. We used logistic regression to test for an association between corticosteroids and complicated course within endotype. MEASUREMENTS AND MAIN
resultsAmong endotype B subjects at intermediate to high pediatric sepsis biomarker risk model-based risk of mortality, corticosteroids were independently associated with more than a 10-fold reduction in the risk of a complicated course (relative risk, 0.09; 95% CI, 0.01-0.54; p = 0.007).
conclusionsA combination of prognostic and predictive strategies based on serum protein and messenger RNA biomarkers can identify a subgroup of children with septic shock who may be more likely to benefit from corticosteroids. Prospective validation of these strategies and the existence of this subgroup are warranted.
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