Denyse Mugwaneza, Edson Rwagasore, Ziad El-Khatib, Pierre Dukuziyaturemye, Jared Omolo, Olivier Nsekuye, Samuel Rwunganira, Maximillian Manzi
Factors Associated with Inappropriate Use of Antibiotics Among Animal Health Professionals in Selected Districts of Rwanda, 2021
Journal of epidemiology and global health
phenotyping analysis includes time course useful understanding mechanisms clinical management postoperative delirium however postoperative delirium fully phenotyped hypothesisfree categorization heterogeneous symptoms may useful understanding mechanisms underlying delirium although evidence currently lacking therefore aimed explore phenotypes postoperative delirium following invasive cancer surgery using datadriven approach minimal prior knowledge recruited patients underwent elective invasive cancer resection surgery participants completed 5 consecutive days delirium assessments using delirium rating scalerevised98 drsr98 severity scale categorized 65 13 questionnaire itemsday 5 days dimensional drsr98 scores using unsupervised machine learning kmeans clustering derive small set grouped features representing distinct symptoms across participants reapplied kmeans clustering set grouped features delineate multiple clusters delirium symptoms participants 286 patients 91 developed delirium defined according diagnostic statistical manual mental disorders fifth edition criteria following first kmeans clustering derived four grouped symptom features 1 mixed motor 2 cognitive higherorder thinking domain perceptual disturbance thought content abnormalities 3 acute temporal response 4 sleepwake cycle disturbance subsequent kmeans clustering permitted classification participants seven subgroups cognitive higherorder thinking domain dominant delirium ii prolonged delirium iii acute brief delirium iv subsyndromal deliriumenriched v subsyndromal deliriumenriched insomnia vi insomnia vii fit found patients undergone invasive cancer resection delineated using unsupervised machine learning three delirium clusters two subsyndromal delirium clusters insomnia cluster validation clusters research pathophysiology underlying cluster help elucidate mechanisms postoperative delirium invasive cancer surgery