Insulin sensitivity and sepsis score: A correlation between model-based metric and sepsis scoring system in critically ill patients

Type of content
Journal Article
Thesis discipline
Degree name
Publisher
University of Canterbury. Mechanical Engineering
Journal Title
Journal ISSN
Volume Title
Language
Date
2016
Authors
Suhaimi, F.M.
Chase, Geoff
Pretty, C.G.
Shaw, Geoff
Razak, N.N.
Jamaludin, U.K.
Abstract

Sepsis is highly correlated with mortality and morbidity. Sepsis is a clinical condition demarcated as the existence of infection and systemic inflammatory response syndrome, SIRS. Confirmation of infection requires a blood culture test, which requires incubation, and thus results take at least 48 hours for a syndrome that requires early direct treatment. Since sepsis has a strong inflammatory component, it is hypothesized that metabolic markers affected by inflammation, such as insulin sensitivity, might provide a metric for more rapid, real-time diagnosis. This study uses clinical data from 30 sepsis patients (7624 hours in ICU) of whom 60% are male. Median age and median Apache II score are 63 years and 19, respectively. Model-identified insulin sensitivity (SI) profiles were obtained for each patient, and insulin sensitivity and its hourly changes were correlated with modified hourly sepsis scores (SSH1). SI profiles and values were similar across the cohort. The sepsis score is highly variable and changes rapidly. The modified hourly sepsis score, SSH1, shows a better relation with insulin sensitivity due to less fluctuation in the SIRS element. Median SI and ΔSI of the cohort is 4.193e-4 and 4.253e-6 L/mU.min, respectively. P-values are 0.0392 (SSH1 = 0, SSH1 = 2), 0.3337 (SSH1 = 0, SSH1 = 3), and 0.0581 (SSH1 = 1, SSH1 = 2), respectively. CDF of SI indicates that insulin sensitivity is more significant when comparing hourly sepsis score at a very distinguish level.

Description
Citation
Suhaimi, F.M., Chase, J.G., Pretty, C.G., Shaw, G.M., Razak, N.N., Jamaludin, U.K. (2016) Insulin sensitivity and sepsis score: A correlation between model-based metric and sepsis scoring system in critically ill patients. Biomedical Signal Processing and Control, (in press).
Keywords
glucose-insulin model, ICU, insulin sensitivity, sepsis, sepsis score
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Field of Research::11 - Medical and Health Sciences::1108 - Medical Microbiology::110802 - Medical Infection Agents (incl. Prions)
Fields of Research::32 - Biomedical and clinical sciences::3202 - Clinical sciences::320208 - Endocrinology
Fields of Research::40 - Engineering::4003 - Biomedical engineering::400303 - Biomechanical engineering
Rights
Creative Commons Attribution Non-Commercial No Derivatives License