JAMA network open
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Multiple organ dysfunction syndrome (MODS) is a dynamic and heterogeneous process associated with high morbidity and mortality in critically ill children. ⋯ In this study, data-driven phenotyping in critically ill children with MODS uncovered 4 distinct and reproducible phenotypes with prognostic relevance and possible therapeutic relevance. Further validation and characterization of these phenotypes is warranted.
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Whether the cardiopulmonary resuscitation (CPR) preferences of patients receiving dialysis align with their values and other aspects of end-of-life care is not known. ⋯ The CPR preferences of patients receiving dialysis were associated with some, but not all, other aspects of end-of-life care. How participants responded to questions about these other aspects of end-of-life care were not always aligned with their CPR preference. More work is needed to integrate discussions about code status with bigger picture conversations about patients' values, goals, and preferences for end-of-life care.
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Multicenter Study
Internal and External Validation of a Machine Learning Risk Score for Acute Kidney Injury.
Acute kidney injury (AKI) is associated with increased morbidity and mortality in hospitalized patients. Current methods to identify patients at high risk of AKI are limited, and few prediction models have been externally validated. ⋯ In this study, the machine learning algorithm demonstrated excellent discrimination in both internal and external validation, supporting its generalizability and potential as a clinical decision support tool to improve AKI detection and outcomes.
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The optimum duration of adjuvant trastuzumab among patients with early breast cancer is uncertain but of great therapeutic relevance. ⋯ In this study, a shorter duration of adjuvant trastuzumab was noninferior to its 1-year administration and resulted in lower rates of cardiac toxic effects. These results suggest that a shorter duration may be the preferred option for patients with low-risk disease or a predisposition to cardiac toxic effects.