Identifying septic shock subgroups to tailor fluid strategies through multi-omics integration
Fluid management remains a critical challenge in the treatment of septic shock, with individualized approaches lacking. This study aims to develop a statistical model based on transcriptomics to identify subgroups of septic shock patients with varied responses to fluid strategy. The study encompasses 494 septic shock patients. A benefit score is derived from the transcriptome space, with higher values indicating greater benefits from restrictive fluid strategy. Adherence to the recommended strategy is associated with a hazard ratio of 0.82 (95% confidence interval: 0.64-0.92). When applied to the baseline hospital mortality rate of 16%, adherence to the recommended fluid strategy could potentially lower this rate to 13%. A proteomic signature comprising six proteins is developed to predict the benefit score, yielding an area under the curve of 0.802 (95% confidence interval: 0.752-0.846) in classifying patients who may benefit from a restrictive strategy. In this work, we develop a proteomic signature with potential utility in guiding fluid strategy for septic shock patients.
Authors
- Xuandong Jiang (ORCID: https://orcid.org/0000-0002-6533-8112)
- Zhanwei Ruan (ORCID: https://orcid.org/0000-0001-6069-0160)
- Wei-Min Zhang (ORCID: https://orcid.org/0000-0003-2117-3608)
- Shaojiang Zheng (ORCID: https://orcid.org/0000-0002-2323-0736)
- Bingshu Wang (ORCID: https://orcid.org/0000-0002-2603-8328)
- Zhitao Zhong
- Zhongheng Zhang (ORCID: https://orcid.org/0000-0002-2336-5323)
- Lin Chen (ORCID: https://orcid.org/0000-0001-5890-7682)
- Lingxia Cheng
- Bin Sun (ORCID: https://orcid.org/0009-0003-0943-2838)
- Pan Pan (ORCID: https://orcid.org/0000-0002-7214-1393)
- Jie Yang (ORCID: https://orcid.org/0000-0001-8267-775X)
- Ping Xu (ORCID: https://orcid.org/0000-0003-1379-4295)
- Lina Xian
- Hongying Ni (ORCID: https://orcid.org/0000-0002-9474-7978)
- Yucai Hong (ORCID: https://orcid.org/0009-0004-3780-6670)
- Shaowen Cheng
- Haifeng Zhang (ORCID: https://orcid.org/0000-0003-1938-3796)
Institutions
- Binzhou Medical University (CN)
- Shandong University of Aeronautics (CN)
- Shaoxing University (CN)
- Wenzhou Medical University (CN)
- Sir Run Run Shaw Hospital (CN)
- Chinese PLA General Hospital (CN)
- Zigong First People's Hospital (CN)
- Dongyang People's Hospital (CN)
- Jinhua Central Hospital (CN)
- Zhejiang University (CN)
- Hainan Medical University (CN)
Publication Details
- Journal
- Nature Communications
- Published
- 2024-10-19
- DOI
- https://doi.org/10.1038/s41467-024-53239-9
- Citations
- 29
- Primary Topic
- Metabolomics and Mass Spectrometry Studies
- Type
- article
- Field-Weighted Citation Impact
- 7.01
Funders
- National Natural Science Foundation of China
- National Key Research and Development Program of China
- Zhejiang Traditional Chinese Medicine Administration
- Natural Science Foundation of Zhejiang Province
- Science and Technology Program of Zhejiang Province