Pediatric Sepsis Phenotype in a Single-Center Cohort… : Pediatric Critical Care Medicine
demic children’s hospital. PATIENTS: One thousand eight hundred twenty-eight children (1 mo to 18 yr old) admitted to the PICU with suspected infection who received a minimum of 7 days of systemic antibiotics. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Subjects showed significant evolution of phenotype from day 1 to day 3, with 31.7–60.9% remaining the same type. Outcomes were worst in those classifying as type D on day 3, with mortality as high as 16.6% in those that were classified as type D on both days 1 and 3, as well as 11.3% in those initially classified as type C (a lower mortality type) on day 1 but type D on day 3. Accurate statistical prediction of day 3 types using multinomial logistic regression and random forest and day 1 data was poor, despite attempts to improve performance. CONCLUSIONS: In our retrospective cohort of patients with sepsis, we identified significant evolution in phenotype over the first 3 days of illness. Day 3 phenotypes may provide more accura
