Machine learning-driven pathogen cluster analysis identifies high-risk subtypes of infected pancreatic necrosis in a multi-center cohort

Table 1 Baseline of clusters in the derivation cohort, n (%)

Characteristics	Levels	Cluster α (n = 112)	Cluster β (n = 78)	Cluster γ (n = 152)	Cluster δ (n = 54)	P value
Age	mean ± SD	46.5 ± 13.8	45.9 ± 12.8	47.0 ± 12.2	49.2 ± 12.3	0.498
Gender	Female	30 (26.8)	21 (26.9)	37 (24.3)	14 (25.9)	0.964
	Male	82 (73.2)	57 (73.1)	115 (75.7)	40 (74.1)
Complications	No	73 (65.2)	56 (71.8)	111 (73)	35 (64.8)	0.453
	Yes	39 (34.8)	22 (28.2)	41 (27)	19 (35.2)
Smoking or drinking	No	68 (60.7)	43 (55.1)	87 (57.2)	31 (57.4)	0.887
	Yes	44 (39.3)	35 (44.9)	65 (42.8)	23 (42.6)
Etiology	Biliary	56 (50)	37 (47.4)	76 (50)	28 (51.9)	0.820
	Hypertriglyceridemia	36 (32.1)	27 (34.6)	46 (30.3)	12 (22.2)
	Alcoholic	4 (3.6)	4 (5.1)	6 (3.9)	5 (9.3)
	Other	16 (14.3)	10 (12.8)	24 (15.8)	9 (16.7)
Severity classification	Critical acute pancreatitis	49 (43.8)	33 (42.3)	94 (61.8)	36 (66.7)	0.001
APACHE II score	Median (IQR)	8.0 (5.0-12.0)	8.0 (5.0-14.0)	9.0 (5.0-15.0)	11.5 (6.0-20.0)	0.051
BISAP score	Median (IQR)	2.0 (1.0-3.0)	2.0 (1.0-2.0)	2.0 (2.0-3.0)	2.0 (2.0-3.0)	0.007
Number of organ failures	No	64 (57.1)	42 (53.8)	55 (36.2)	17 (31.5)	0.002
	Single organ failure	19 (17)	18 (23.1)	33 (21.7)	13 (24.1)
	Multiple organ failure	29 (25.9)	18 (23.1)	64 (42.1)	24 (44.4)
Respiratory failure	No	73 (65.2)	48 (61.5)	65 (42.8)	20 (37)	< 0.001
	Yes	39 (34.8)	30 (38.5)	87 (57.2)	34 (63)
Renal failure	No	78 (69.6)	57 (73.1)	92 (60.5)	29 (53.7)	0.055
	Yes	34 (30.4)	21 (26.9)	60 (39.5)	25 (46.3)
Circulation failure	No	90 (80.4)	68 (87.2)	104 (68.4)	42 (77.8)	0.009
	Yes	22 (19.6)	10 (12.8)	48 (31.6)	12 (22.2)
ICU stay	No	39 (34.8)	35 (44.9)	29 (19.1)	17 (31.5)	< 0.001
	Yes	73 (65.2)	43 (55.1)	123 (80.9)	37 (68.5)
Duration of ICU stay	Median (IQR)	5.0 (0.0-17.0)	2.5 (0.0-13.0)	10.0 (3.0-21.5)	9.0 (0.0-18.0)	< 0.001
Surgery approach	Step-up approach	95 (84.8)	66 (84.6)	128 (84.2)	47 (87)	0.969
	Step-down approach	17 (15.2)	12 (15.4)	24 (15.8)	7 (13)
The number of surgery intervention	Median (IQR)	3.0 (2.0-4.0)	3.0 (2.0-5.0)	4.0 (3.0-6.0)	3.5 (2.0-6.0)	0.024
Invasive ventilation	No	64 (57.1)	53 (67.9)	91 (59.9)	23 (42.6)	0.034
	Yes	48 (42.9)	25 (32.1)	61 (40.1)	31 (57.4)
CRRT	No	91 (81.2)	71 (91)	109 (71.7)	32 (59.3)	< 0.001
	Yes	21 (18.8)	7 (9)	43 (28.3)	22 (40.7)
CVC indwelling	No	73 (65.2)	53 (67.9)	84 (55.3)	19 (35.2)	< 0.001
	Yes	39 (34.8)	25 (32.1)	68 (44.7)	35 (64.8)
Vasopressor administration	No	82 (73.2)	66 (84.6)	86 (56.6)	31 (57.4)	< 0.001
	Yes	30 (26.8)	12 (15.4)	66 (43.4)	23 (42.6)
Hemorrhage	No	89 (80.9)	64 (82.1)	111 (73)	43 (79.6)	0.314
	Yes	21 (19.1)	14 (17.9)	41 (27)	11 (20.4)
Pancreatic fistula	No	58 (52.7)	54 (69.2)	87 (58)	38 (70.4)	0.049
	Yes	52 (47.3)	24 (30.8)	63 (42)	16 (29.6)
Gastrointestinal fistula	No	99 (90)	66 (84.6)	119 (78.3)	48 (88.9)	0.053
	Yes	11 (10)	12 (15.4)	33 (21.7)	6 (11.1)
Bloodstream infection	No	88 (78.6)	65 (83.3)	89 (58.6)	44 (81.5)	< 0.001
	Yes	24 (21.4)	13 (16.7)	63 (41.4)	10 (18.5)
Peripancreatic polymicrobial infection	No	46 (41.1)	32 (41)	44 (28.9)	33 (61.1)	< 0.001
	Yes	66 (58.9)	46 (59)	108 (71.1)	21 (38.9)
Pancreatic fungal infection	No	83 (74.1)	66 (84.6)	111 (73)	37 (68.5)	0.144
	Yes	29 (25.9)	12 (15.4)	41 (27)	17 (31.5)
Pancreatic MDRO infection	No	79 (70.5)	44 (56.4)	40 (26.3)	21 (38.9)	< 0.001
	Yes	33 (29.5)	34 (43.6)	112 (73.7)	33 (61.1)
Death	No	89 (79.5)	70 (89.7)	112 (73.7)	37 (68.5)	0.013
	Yes	23 (20.5)	8 (10.3)	40 (26.3)	17 (31.5)

α: Enterococcus faecium/Enterobacter cloacae–predominant; β: Escherichia coli–dominant; γ: Multidrug-resistant organism-enriched; δ: Acinetobacter baumannii–Candida glabrata; APACHE II score: Acute Physiology and Chronic Health Examination II score; BISAP score: Bedside Index of Severity in Acute Pancreatitis score; CRRT: Continuous renal replacement therapy; CVC: Central venous catheter; MDRO: Multidrug-resistant organisms; ICU: Intensive care unit; IQR: Interquartile range.