Evidence mapPaperPMID 38730421Full record

ArticleCritical care (London, England)2024

Machine learning derived serum creatinine trajectories in acute kidney injury in critically ill patients with sepsis.

Kullaya Takkavatakarn, Wonsuk Oh, Lili Chan, Ira Hofer, Khaled Shawwa, Monica Kraft, Neomi Shah, Roopa Kohli-Seth, Girish N Nadkarni, Ankit Sakhuja

Abstract read
In one paragraph

Article in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Kullaya Takkavatakarn *Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Wonsuk Oh *The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Lili ChanDivision of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Ira HoferDivision of Data Driven and Digital Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Khaled ShawwaDivision of Nephrology, Department of Medicine, West Virginia University, Morgantown, WV, USA.
Monica KraftDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Neomi ShahDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Roopa Kohli-SethInstitute for Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Girish N Nadkarni *Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Ankit Sakhuja *The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. ankit.sakhuja@mssm.edu.

Funding

Elucidating Genetic and Environmental Second Hits in Racial and Ethnic Minorities with APOL1 High-Risk GenotypesR01DK127139 · NIDDK · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2022 to 2025
$2.6M
Improving risk prediction of adverse outcomes in hemodialysis patients by incorporating non-traditional risk factorsK23DK124645 · NIDDK · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2022 to 2025
$761k
Application of Machine Learning to Identify Obstructive Sleep Apnea Subgroups at Risk for Atherosclerosis Progression and Cardiovascular Disease Events (OSA-GRANDE)R01HL168897 · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2025 to 2025
$744k
Using Novel Machine Learning Methods to Personalize Strategies for Prevention of Persistent AKI after Cardiac SurgeryK08DK131286 · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2025 to 2025
$156k
NHLBI NIH HHS R01 HL143221NHLBI NIH HHS R01 HL168897NIDDK NIH HHS 5K08DK131286NIDDK NIH HHS K08 DK131286NIDDK NIH HHS K23 DK124645NIDDK NIH HHS R01 DK127139NIDDK NIH HHS R01DK127139NIH HHS S10 OD026880NIH HHS S10 OD030463
6 · The paper itself

Abstract

backgroundCurrent classification for acute kidney injury (AKI) in critically ill patients with sepsis relies only on its severity-measured by maximum creatinine which overlooks inherent complexities and longitudinal evaluation of this heterogenous syndrome. The role of classification of AKI based on early creatinine trajectories is unclear.

methodsThis retrospective study identified patients with Sepsis-3 who developed AKI within 48-h of intensive care unit admission using Medical Information Mart for Intensive Care-IV database. We used latent class mixed modelling to identify early creatinine trajectory-based classes of AKI in critically ill patients with sepsis. Our primary outcome was development of acute kidney disease (AKD). Secondary outcomes were composite of AKD or all-cause in-hospital mortality by day 7, and AKD or all-cause in-hospital mortality by hospital discharge. We used multivariable regression to assess impact of creatinine trajectory-based classification on outcomes, and eICU database for external validation.

resultsAmong 4197 patients with AKI in critically ill patients with sepsis, we identified eight creatinine trajectory-based classes with distinct characteristics. Compared to the class with transient AKI, the class that showed severe AKI with mild improvement but persistence had highest adjusted risks for developing AKD (OR 5.16; 95% CI 2.87-9.24) and composite 7-day outcome (HR 4.51; 95% CI 2.69-7.56). The class that demonstrated late mild AKI with persistence and worsening had highest risks for developing composite hospital discharge outcome (HR 2.04; 95% CI 1.41-2.94). These associations were similar on external validation.

conclusionsThese 8 classes of AKI in critically ill patients with sepsis, stratified by early creatinine trajectories, were good predictors for key outcomes in patients with AKI in critically ill patients with sepsis independent of their AKI staging.

Indexed as

Acute Kidney InjuryCreatinineCritical IllnessMachine LearningSepsisAgedBiomarkersFemaleHospital MortalityHumansIntensive Care UnitsMaleMiddle AgedRetrospective StudiesBiomarkersCreatinineAcute kidney injuryCreatinine trajectoryCritical careSepsis

Identifiers

PMID38730421
PMCPMC11084026

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.