Nature Communications (Oct 2024)

Identifying septic shock subgroups to tailor fluid strategies through multi-omics integration

  • Zhongheng Zhang,
  • Lin Chen,
  • Bin Sun,
  • Zhanwei Ruan,
  • Pan Pan,
  • Weimin Zhang,
  • Xuandong Jiang,
  • Shaojiang Zheng,
  • Shaowen Cheng,
  • Lina Xian,
  • Bingshu Wang,
  • Jie Yang,
  • Bo Zhang,
  • Ping Xu,
  • Zhitao Zhong,
  • Lingxia Cheng,
  • Hongying Ni,
  • the Chinese Multi-omics Advances In Sepsis (CMAISE) Consortium,
  • Yucai Hong

DOI
https://doi.org/10.1038/s41467-024-53239-9
Journal volume & issue
Vol. 15, no. 1
pp. 1 – 14

Abstract

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Abstract 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.