Corticosteroids for infectious critical illness: A multicenter target trial emulation stratified by predicted organ dysfunction trajectory.

ABSTRACT: Corticosteroids decrease the duration of organ dysfunction in a range of infectious critical illnesses, but their risk and benefit are not fully defined using this construct. This retrospective multicenter study aimed to evaluate the association between usage of corticosteroids and mortality of patients with infectious critical illness by emulating a target trial framework. The study employed a novel stratification method with predictive machine learning (ML) subphenotyping based on organ dysfunction trajectory. Our analysis revealed that corticosteroids' effectiveness varied depending on the stratification method. The ML-based approach identified four distinct subphenotypes, two of which had a large enough sample size in our patient cohorts for further evaluation: "Rapidly Improving" (RI)

SUBMITTER: Rajendran S 

PROVIDER: S-EPMC10942524 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature