Publications by authors named "Kimberley M DeMerle"
Article Synopsis
- Despite previous trials, it's still unclear how to effectively resuscitate patients with septic shock, prompting a deeper look into individual differences in treatment responses.
- The study utilized machine learning to predict individual patient risk differences and evaluate how their characteristics affected treatment effectiveness across two large cohorts.
- Results indicated significant variability in treatment responses; patients predicted to have the highest risks improved with early goal-directed therapy (EGDT), while those at lower risk potentially faced harm from the same treatment.
Article Synopsis
- The study analyzes sepsis phenotypes using clinical and protein biomarker data from the ProCESS trial, finding two distinct phenotypes based on 20 variables.
- Phenotype 1 (12% of patients) showed higher levels of inflammation and organ dysfunction, leading to significantly higher 60-day inpatient mortality compared to Phenotype 2 (88% of patients).
- The effectiveness of early, goal-directed therapy (EGDT) versus usual care also varied by phenotype, with EGDT performing poorly in Phenotype 1 but similarly to usual care in Phenotype 2.
Importance: A cornerstone of precision medicine is the identification and use of biomarkers that help subtype patients for targeted treatment. Such an approach requires the development and subsequent interrogation of large-scale biobanks linked to well-annotated clinical data. Traditional means of creating these data-linked biobanks are costly and lengthy, especially in acute conditions that require time-sensitive clinical data and biospecimens.
View Article and Find Full Text PDFSepsis is defined as a dysregulated host response to infection that leads to life-threatening acute organ dysfunction. It afflicts approximately 50 million people worldwide annually and is often deadly, even when evidence-based guidelines are applied promptly. Many randomized trials tested therapies for sepsis over the past 2 decades, but most have not proven beneficial.
View Article and Find Full Text PDFBackground: Infection is a leading cause of hospitalization with high morbidity and mortality, but there are limited data to guide the duration of antibiotic therapy.
Purpose: Systematic review to compare outcomes of shorter versus longer antibiotic courses among hospitalized adults and adolescents.
Data Sources: MEDLINE and Embase databases, 1990-2017.
Objectives: Sepsis hospitalizations are frequently followed by hospital readmissions, often for recurrent sepsis. However, it is unclear how often sepsis readmissions are for relapsed/recrudescent versus new infections. The aim of this study was to assess the extent to which 90-day readmissions for recurrent sepsis are due to infection of the same site and same pathogen as the initial episode.
View Article and Find Full Text PDFPurpose: We sought to measure inpatient healthcare utilization among U.S. Veteran Affairs beneficiaries surviving sepsis hospitalization, and to examine how post-sepsis utilization varies by select patient characteristics.
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