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Walkey et al. Prognostic accuracy of pre-sepsis and intra-sepsis characteristics for prediction of cardiovascular events after a sepsis hospitalization data
Data Supplement Contents
Page 2 Table E1. Administrative codes used to define outcomes
Page 6 Table E2. Framework depicting timing of variables during sepsis encounter and outcomes
Page 7 Table E3. Full characteristics of patients hospitalized with sepsis within Kaiser Permanente Northern California and Intermountain healthcare systems
Page 10 Table E4. Missing data
Page 11 Table E5. Effect estimates from combined cardiovascular outcome models Page 14 eFigure 1a. Calibration plots Kaiser Permanente Northern California-
derived models predicting post-sepsis cardiovascular events within Kaiser Permanente Northern California healthcare system.
Page 15 eFigure 1b. Distribution of predicted risk for cardiovascular outcomes in Kaiser Permanente Northern California data
Page 16 eFigure 2a. Calibration plots Intermountain Healthcare models predicting post-sepsis cardiovascular events within Intermountain Healthcare
system.
Page 17 eFigure 2b. Distribution of predicted risk for cardiovascular outcomes in Intermountain healthcare.
Page 18 eFigure 3. Calibration plots of Intermountain Healthcare models predicting post-sepsis cardiovascular events cross validated within data from sepsis survivors at Kaiser Permanente Northern California.
Page 19 eFigure 4. Calibration plots of Kaiser Permanente Northern California models predicting post-sepsis cardiovascular events cross validated within data from sepsis survivors at Intermountain Healthcare.
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Table E1. Administrative codes used to define outcomes
ICD-9 ICD-10
Atherosclerotic cardiovascular disease:
Acute myocardial infarction, ischemic stroke, transient ischemic attack, coronary artery bypass,
percutaneous coronary intervention,
ruptured abdominal aortic aneurysm, peripheral vascular disease
429.2, 413, 36.01-36.02, 36.05, 36.06, 36.09, 36.1- 36.17, 36.19, 410, 433.x1, 434.x1, 436.0, 435, 36.10- 36.17, 36.19, 410, 410.0, 410.00, 410.01, 410.1, 410.10, 433.01, 433.11, 410.11, 410.2, 410.20, 410.21, 410.3, 410.30, 410.31, 410.4, 410.40, 410.41, 410.5, 410.50, 410.51, 410.6, 410.60, 410.61, 410.7, 410.70, 410.71, 410.8, 410.81, 410.9, 410.90, 410.91, 433.21, 433.31, 434.01, 434.11, 434.91, 433.81, 433.91, 435, 435.0, 435.1, 435.2, 435.3, 435.8, 435.9, 440.21, 440.22, 440.23 440.24, 440.3, 440.30, 440.31, 440.32, 440.4, 441, 441.0, 441.00, 441.01, 441.02, 441.03, 441.1, 441.2, 441.3, 441.4, 441.5, 441.6, 441.7, 441.9, 442.0, 442.1, 442.2, 442.3, 442.8, 442.81, 442.82, 442.84, 442.89, 442.9, 443.1, 443.2, 443.21, 443.22, 443.23, 443.24, 443.29
I48, I48.0-I48.2, I48.9, I48.91, Z82.49, I21, I21.0, I21.01, I21.02, I21.09, I21.1, I21.11, I21.19, I21.2, I21.21, I21.29, I21.3, I21.4, I21.9, I21.A, I21.A1, I21.A9, I22, I22.0, I22.1, I22.2, I22.8, I22.9, I23.0, I23.1-I23.6, I23.8, I70.2, I70.20, I70.201, I70.202, I70.203, I70.208, I70.209, I70.211, I70.212, I70.213, I70.218, I70.219, I70.221, I70.222, I70.223, I70.228, I70.229, I70.231, I70.232, I70.233, I70.234, I70.235, I70.238, I70.239, I70.241, I70.242, I70.243, I70.244, I70.245, I70.248, I70.249, I70.25, I70.261, I70.262, I70.263, I70.268, I70.269, I70.29, I70.291, I70.292, I70.293, I70.298, I70.299, I70.3, I70.301, I70.302, I70.303, I70.308, I70.309, I70.311, I70.312, I70.313, I70.318, I70.319, I70.321, I70.322, I70.323, I70.328, I70.329, I70.33, I70.331, I70.332, I70.333, I70.334, I70.335, I70.338, I70.339, I70.34, I70.341, I70.342, I70.343, I70.344, I70.345, I70.348, I70.349, I70.35, I70.361, I70.362, I70.363, I70.368, I70.369, I70.391, I70.392, I70.393, I70.398, I70.399, I70.401, I70.402, I70.403, I70.408, I70.409, I70.411, I70.412, I70.413, I70.418, I70.419, I70.421, I70.422, I70.423, I70.428, I70.429, I70.43, I70.431, I70.432, I70.433, I70.434, I70.435, I70.438, I70.439, I70.44, I70.441, I70.442, I70.443, I70.444, I70.445, I70.448, I70.449, I70.45, I70.461, I70.462, I70.463, I70.468, I70.469,
3
I70.491, I70.492, I70.493, I70.498, I70.499, I70.501, I70.502, I70.503, I70.508, I70.509, I70.511, I70.512, I70.513, I70.518, I70.519, I70.521, I70.522, I70.523, I70.528, I70.529, I70.53, I70.531, I70.532, I70.533, I70.534, I70.535, I70.538, I70.539, I70.54, I70.541, I70.542, I70.543, I70.544, I70.545, I70.548, I70.549, I70.55, I70.561, I70.562, I70.563, I70.568, I70.569, I70.591, I70.592, I70.593, I70.598, I70.599, I70.601, I70.602, I70.603, I70.608, I70.609, I70.611, I70.612, I70.613, I70.618, I70.619, I70.621, I70.622, I70.623, I70.628, I70.629, I70.631, I70.632, I70.633, I70.634, I70.635, I70.638, I70.639, I70.641, I70.642, I70.643, I70.644, I70.645, I70.648, I70.649, I70.65, I70.661, I70.662, I70.663, I70.668, I70.669, I70.691, I70.692, I70.693, I70.698, I70.699, I70.7, I70.701, I70.702, I70.703, I70.708, I70.709, I70.711, I70.712, I70.713, I70.718, I70.719, I70.721, I70.722, I70.723, I70.728, I70.729, I70.731, I70.732, I70.733, I70.734, I70.735, I70.738, I70.739, I70.74, I70.741, I70.742, I70.743, I70.744, I70.745, I70.748, I70.749, I70.75, I70.761, I70.762, I70.763, I70.768, I70.769, I70.791, I70.792, I70.793, I70.798, I70.799, I70.92, I71, I71.0, I71.00, I71.01, I71.02, I71.03, I71.1, I71.2, I71.3, I71.4, I71.5, I71.6, I71.8, I71.9, I72.0, I72.1, I72.2, I72.3, I72.4, I72.5, I72.6, I73.1, I74.0, I74.01, I74.09, I74.1, I74.10, I74.11, I74.19, I74.2, I74.3, I74.4, I74.5, I77.71, I77.72, I77.73, I77.74, I77.75, I77.76, I77.77, G43.6, G43.601, G43.609,
4
G43.611, G43.619, G46.3, G46.4, G95.11, I63, I63.0, I63.00, I63.01, I63.011, I63.012, I63.013, I63.019, I63.02, I63.03, I63.031, I63.032, I63.033, I63.039, I63.09, I63.1, I63.10, I63.11, I63.111, I63.112, I63.113, I63.119, I63.12, I63.13, I63.131, I63.132, I63.133, I63.139, I63.19, I63.2, I63.20, I63.21, I63.211, I63.212, I63.213, I63.219, I63.22, I63.23, I63.231, I63.232, I63.233, I63.239, I63.29, I63.3, I63.30, I63.31, I63.311, I63.312, I63.313, I63.319, I63.32, I63.321, I63.322, I63.323, I63.329, I63.33, I63.331, I63.332, I63.333, I63.339, I63.34, I63.341, I63.342, I63.343, I63.349, I63.39, I63.4, I63.40, I63.41, I63.411, I63.412, I63.413, I63.419, I63.42, I63.421, I63.422,
I63.423, I63.429, I63.43, I63.431, I63.432, I63.433, I63.439, I63.44, I63.441, I63.442, I63.443, I63.449, I63.49, I63.5, I63.50, I63.51, I63.511, I63.512, I63.513, I63.519, I63.52, I63.521, I63.522, I63.523, I63.529, I63.53, I63.531, I63.532, I63.533, I63.539, I63.54, I63.541, I63.542, I63.543, I63.549, I63.59, I63.6, I63.8, I63.9, I97.810, I97.811, I97.82, I97.820, I97.821, G45, G45.0, G45.1, G45.2, G45.3, G45.8, G45.9, G46.0, G46.1, G46.2, I67.84, I67.841, G45.848, M47.0, M47.02, M47.021, M47.022, M47.029 Heart failure 398.91, 402.01, 402.11,
402.91, 428.0, 428.1, 428.9, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428.20-428.23, 428.3, 428.30-428.33, 428.4, 428.40-428.43
I09.81, I11.0, I13.0, I13.2, I50, I50.0- I50.2, I50.20-I50.23, I50.3, I50.30- I50.33, I40, I40-I43, I50.8, I50.81, I50.810-I50.814, I50.82-I50.84, I50.89, I50.9, I97.13,
5
Atrial fibrillation 427.3, 427.31 I48, I48.0, I48.1, I48.2, I48.9 Abbreviations: ICD=International Classification of Disease
6
Table E2. Framework depicting timing of variables during sepsis encounter and outcomes
Time
Baseline Factors Pre-Sepsis Factors Intra-Sepsis Factors
Outcomes (1 year)
Age Sex Race
Home medications (3-month look- back)
Kidney-disease related variables (1- year look-back)
5-year look-back
Smoking history Comorbidities Outpatient vital signs
Outpatient labs
Type/site of infection
Severity of illness scores
Blood transfusions Inpatient vital signs Inpatient labs Inpatient medications
% of time with atrial fibrillation on
flowsheet Receipt of vasopressors Receipt of
ventilatory support
Combined cardiovascular events
Atherosclerotic event
Heart failure Atrial fibrillation
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Table e3. Full characteristics of patients hospitalized with sepsis within Kaiser Permanente Northern California and Intermountain healthcare systems.
Kaiser Permanente Intermountain
N=39,590 N=16,388
Demographic variables
Age at admission 70.0 [60.0, 81.0] 66.0 [56.0-76.0]
Male sex 18276 (46.2) 7894 (48.2)
Race/ethnicity
Asian/Pacific Islander 5301 (13.4) 200 (1.2) Black 3368 (8.5) 133 (0.8) Hispanic 5590 (14.1) 1417 (8.6)
Native American/Alaska Native 396 (1.0) 167 (1.0)
White 24817 (62.7) 13835 (84.4)
Other 118 (0.3) 636 (3.9)
Presepsis Variables
Body mass index 26.91 [23.02, 31.97] 28.3 [24.1-33.6]
ACC/AHA ASCVD risk* 0.111 [0.031, 0.256] 0.075 [0.026-0.188]
Systolic blood pressure, mmHg 127.0 [116.0, 137.0] 130 [118-143]
Total cholesterol, mg/dL 180.0 [151.0, 199.0] 172 [144-203]
HDL cholesterol, mg/dL 51.0 [41.0, 58.0] 44 [36-54]
Left ventricular ejection fraction, % 60.0 [60.0, 60.0] 64 [60-68]
Charlson comorbidity score 2 [1, 5] 0 [0-2]
Chronic pulmonary disease 13324 (33.7) 1500 (9.2)
Dementia 1829 (4.6) 635 (3.9)
Uncomplicated diabetes 13233 (33.4) 956 (5.8)
Diabetes with complications 9205 (23.3) 1290 (7.9)
AIDS 263 (0.7) <50 (<0.5)
Localized malignancy 8956 (22.6) 1433 (8.7)
Metastatic malignancy 3677 (9.3) 637 (3.9)
Mild liver disease 2024 (5.1) 1043 (6.4)
Severe liver disease 1363 (3.4) 340 (2.1)
Plegia/neuromuscular 675 (1.7) 203 (1.2)
Peptic ulcer disease 1383 (3.5) 435 (2.7)
Peripheral vascular disease 7411 (18.7) 1184 (7.2)
Chronic kidney disease 12956 (32.7) 3524 (21.5)
Rheumatologic Disease 1819 (4.6) 306 (1.9)
Other clinical history
Proteinuria 4727 (11.9) 73 (0.4)
Dyslipidemia 24416 (61.7) 5165 (31.5)
Dialysis 603 (1.5) 106 (0.6)
8
Kidney transplant 332 (0.8) 133 (0.8)
Current or former cigarette smoking 17940 (45.3) 5192 (31.7) Medications
Antiplatelet therapy (other than
aspirin) 448 (1.1)
500 (3.1)
Aspirin 685 (1.7) 477 (2.9)
Antihypertensive therapy with 120
days prior 25897 (65.4)
2367 (14.4)
Statin therapy 14808 (37.4) 1345 (8.2)
Antihypertensive therapy diagnosis
in year prior to sepsis 21841 (55.2) 3450 (21.1)
Intra-sepsis variables
Treated in intensive care unit 10192 (25.7) 5461 (33.3) Length of hospital stay, days 4.0 [2.8, 6.0] 3.4 [2.2, 5.2]
Patients with a cardiac flow sheet
which documented atrial fibrillation 3129(8.1) 1100 (6.7) Received hemodialysis while inpatient 474 (1.2) 266 (1.6) Total net fluid balance during
hospitalization (ml)
1480[-780, 4047] 1985 [-252, 4289]
Received invasive mechanical
ventilation 2670 (6.7)
1053 (6.4) Received non-invasive ventilation 3093 (7.8) 2480 (15.1)
Received blood product 5785 (14.6) 1237 (7.5)
Highest LAPS2 score* 89 [63, 116] 103 [83, 126]
Highest SOFA score 3 [2, 4] N/A
Day 1 SOFA score N/A 4 (3, 5)
Lowest oxygen saturation (%) 92 [88, 94] 90 [87, 92]
Laboratory values and test results
Highest ALT, U/L 25.0 [23.5, 47.0] 28 [17, 54]
Highest AST, U/L 25.0 [25.0, 52.0] 36 [25, 65]
Highest band, percent 0.0 [0.0, 6.0] 0 [0, 5]
Highest total bilirubin, mg/dL 0.70 [0.70, 1.30] 0.8 [0.5, 1.3]
Highest brain natriuretic peptide,
pg/mL 60.0 [60.0, 60.0]
152 [63, 436]
Highest serum creatinine, mg/dL 1.20 [0.86, 1.83] 1.13 [0.87, 1.60]
First inpatient ejection fraction (%) 60.0 [60.0, 60.0] 63 [55, 68]
Highest glucose, mg/dL 147 [121, 195] 148 [123, 197]
Highest lactic acid, mmol/L 1.4 [1.2, 2.4] 1.9 [1.3, 3.0]
Lowest platelet, x109/L 155 [110, 213] 258 [190, 350]
Highest prothrombin time, seconds 13.4 [13.0, 15.3] 15.3 [14.1, 17.5]
Highest troponin I, ng/mL 0.02 [0.02, 0.02] 0.03 [0.01, 0.12]
Highest white blood cell count 13.1 [9.2-17.9] 13.5 [9.7, 18.2]
Type or location of infection
9
Median (interquartile range) is reported for continuous variables. Number (percent) is reported for binary/categorical variables. All reported variables are pre-imputation.
Abbreviations: LAPS2=Laboratory Acute Physiology Score, version 2, SOFA=sequential organ failure assessment, ALT=alanine aminotransferase, AST=aspartate aminotransferase
* The Laboratory-based Acute Physiology Score version 2 (LAPS2) is assigned based on a patient’s worst vital signs, pulse oximetry, neurological status, and 16 laboratory test results in the 72 hours preceding hospitalization.
Central nervous system, infected
device or post-operative 2507 (6.3) 85 (0.5)
Gastrointestinal 9699 (24.5) 335 (2.0)
Urinary tract 12386 (31.3) 3341 (20.4)
Respiratory 12151 (30.7) 910 (5.6)
Skin, soft tissue or joint 3983 (10.1) 455 (2.8)
Gram negative 2925 (7.4) 359 (2.2)
Gram positive (staphylococcus or streptococcus)
962 (2.4) 721 (4.4)
Other unspecified bacteria 23419 (59.2) 10423 (63.6)
Tuberculosis or fungus 1542 (3.9) N/A
Virus 3647 (9.2) N/A
Inpatient medications
Any Vasopressor 3188 (8.1) 1538 (9.4)
Anticoagulant 3480 (8.8) 2550 (15.6)
Anti-platelet/aspirin 9848 (24.9) 3127 (19.1)
Corticosteroid 7905 (20.0) 5181 (31.6)
Statin 13120 (33.1) 4220 (25.8)
Outcomes
ASCVD Event 996 (2.5) 192 (1.2)
Heart Failure 564 (1.4) 117 (0.7)
Atrial Fibrillation 2,310 (5.8) 371 (2.3)
Combined Cardiovascular Outcome 3,503 (8.8) 600 (3.7)
10 Table E4. Missing data
KPNC missingness rate IH Missingness Rate
Prior Echo* 91.3% 87.2%
Highest BNP 71.9% 74.6%
Highest troponin 64.5% 67.6%
Highest PT 38.6% 57.1%
Highest Bili 32.9% 5.4%
Highest AST 31.3% 5.3%
Highest ALT 30.4% 8.1%
Highest Lactate 24.4% 19.1%
ASCVD 10 year risk % * 13.1% 4.7%
HDL* 12.6% 62.9%
Total cholesterol* 11.9% 62.6%
BMI* 1.8% 1.2%
Systolic blood pressure* 1.6% 19.1%
Highest Glucose 0.03% 0.5%
Highest Creatinine 0.03% 0.5%
Total net fluid balance 0.03% <0.1%
Lowest Platelets 0.02% 0.4%
Highest WBC 0.01% 0.4%
Lowest O2 Sat 0% 17.5%
Highest Band 0% 66.6%
11
*specifies pre-sepsis variables
12
Table E5. Hazard ratio effect estimates from combined cardiovascular outcome models Kaiser Permanente Intermountain
N=39590 N=16388
Demographic variables HR (95% CI) HR (95% CI)
Age at admission 1.02 (1.01-1.02) 1.03 (1.01-1.04)
Male sex 1.02 (0.94-1.11) 1.20 (0.97-1.48)
Race/ethnicity
Asian/Pacific Islander reference reference Black 0.82 (0.69-0.99) 2.13 (0.56-8.04) Hispanic 0.86 (0.74-1.01) 1.04 (0.36-3.01) Native American/Alaska Native 1.37 (0.94-2.00) 0.49 (0.05-4.40)
White 1.02 (0.90-1.15) 1.29 (0.48-3.49)
Other 1.26 (0.62-2.55) 0.77 (0.24-2.46)
Presepsis Variables
Body mass index 1.00 (1.00-1.00) 1.01 (1.00-1.02)
ACC/AHA ASCVD risk* 0.86 (0.65-1.14) 0.78 (0.35-1.75)
ASCVD Diabetes flag 1.17 (0.94-1.45) 1.23 (0.91-1.67)
Systolic blood pressure, mmHg 1.00 (1.00-1.00) 1.01 (1.00-1.01) Total cholesterol, mg/dL 1.00 (1.00-1.00) 1.00 (1.00-1.00) HDL cholesterol, mg/dL 1.00 (0.99-1.00) 0.99 (0.98-1.00) Cardiac ejection fraction, % 1.00 (0.99-1.02) 1.00 (0.97-1.03) Charlson comorbidity score 1.05 (0.96-1.14) 0.99 (0.74-1.38) Chronic pulmonary disease 1.00 (0.89-1.14) 1.05 (0.66-1.67)
Dementia 0.68 (0.53-0.87) 0.68 (0.36-1.28)
Uncomplicated diabetes 0.83 (0.67-1.02) 0.58 (0.33-1.02) Diabetes with complications 1.01 (0.85-1.22) 0.89 (0.44-1.81)
HIV 0.45 (0.17-1.21) n/a
Localized malignancy 0.93 (0.75-1.14) 1.14 (0.55-2.38)
Metastatic malignancy 0.78 (0.51-1.20) 1.05 (0.15-7.46)
Mild liver disease 0.82 (0.59-1.15) 1.02 (0.60-1.75)
Severe liver disease 1.08 (0.69-1.69) 0.72 (0.16-3.23)
Plegia/neuromuscular 1.12 (0.76-1.63) 0.42 (0.09-2.02)
Peptic ulcer disease 0.99 (0.77-1.26) 0.93 (0.44-1.94)
Peripheral vascular disease 1.00 (0.87-1.15) 1.43 (0.91-2.26) Chronic kidney disease 1.07 (0.97-1.18) 0.89 (0.44-1.80) Rheumatologic Disease 1.09 (0.90-1.33) 0.83 (0.37-1.85) Other clinical history
Proteinuria 1.24 (1.11-1.38) 0.82 (0.25-2.69)
Dyslipidemia 0.97 (0.87-1.08) 1.50 (1.18-1.92)
Dialysis 1.25 (0.96-1.64) 2.12 (0.66-6.74)
Transplant 1.22 (0.82-1.83) 0.51 (0.12-2.18)
Current or former cigarette smoking 0.98 (0.90-1.06) 0.85 (0.69-1.06) Medications
Antiplatelet therapy (other than aspirin) 1.37 (1.04-1.82) 2.06 (0.59-7.22)
13
Aspirin 0.97 (0.75-1.25) 0.37 (0.09-1.44)
Antihypertensive therapy with 120 days
prior 1.08 (0.96-1.22)
0.96 (0.70-1.34)
Statin therapy 1.03 (0.91-1.15) 0.94 (0.75-1.52)
Antihypertensive therapy diagnosis in
year prior to sepsis 1.88 (1.69-2.10) 1.21 (0.91-1.62)
Intra-sepsis variables
Treated in intensive care unit 1.23 (1.11-1.37) 1.25 (0.99-1.58) Length of hospital stay, days 1.02 (1.00-1.03) 0.97 (0.93-1.01)
% of cardiac flow sheet with
documented atrial fibrillation 1.03 (1.03-1.03) 1.02 (1.02-1.02) Received hemodialysis while inpatient 1.39 (1.07-1.82) 0.35 (0.14-0.90) Total body balance in milliliters at time
of discharge 1.00 (1.0-1.00) 1.00 (1.00-1.00)
Invasive mechanical ventilation,
duration (days) 0.95 (0.91-1.00) 0.99 (0.95-1.03)
Non-invasive ventilation, duration
(days) 1.01 (0.98-1.05)
1.01 (0.99-1.04) Number of blood products received 1.00 (1.00-1.00) 1.00 (1.00-1.00)
Highest LAPS2 score* 1.00 (1.00-1.00) 1.00 (1.00-1.01)
SOFA score (highest for KPNC, day 1
for IH) 1.00 (0.97-1.03) 0.95 (0.89-1.02)
Lowest oxygen saturation (%) 1.00 (0.99-1.00) 0.99 (0.97-1.01) Laboratory values and test results
Highest ALT, U/L 1.00 (1.00-1.00) 1.00 (1.00-1.00
Highest AST, U/L 1.00 (1.00-1.00) 1.00 (1.00-1.00
Highest band, percent 1.00 (1.00-1.00) 1.01 (1.00-1.02)
Highest total bilirubin, mg/dL 0.99 (0.97-1.02) 1.01 (0.95-1.07) Highest brain natriuretic peptide,
pg/mL 1.00(1.00-1.00)
1.00 (1.00-1.00) Highest serum creatinine, mg/dL 1.04 (1.01-1.06) 1.07 (1.00-1.14) First inpatient ejection fraction (%) 1.00 (0.99-1.01) 0.98 (0.97-0.99) Highest glucose, mg/dL 1.00 (1.00-1.00) 1.00 (1.00-1.00) Highest lactic acid, mmol/L 0.96 (0.94-0.99) 0.94 (0.88-1.00) Lowest platelet, x109/L 1.00 (1.00-1.00) 1.00 (1.00-1.00 Highest prothrombin time, seconds 1.00 (0.99-1.01) 1.01 (1.00-1.03) Highest troponin I, ng/mL 1.00 (0.99-1.01) 1.00 (1.00-1.01) Highest white blood cell count 1.00 (1.00-1.01) 1.01 (1.00-1.02) Type or location of infection
Central nervous system, infected
device or post-operative 1.22 (1.05-1.41) n/a
Gastrointestinal 1.00 (0.91-1.10) 1.51 (0.55-4.15)
Genitourinary 0.97 (0.87-1.07) 0.95 (0.43-2.13)
14
Respiratory 1.10 (1.00-1.20) 1.61 (0.69-3.73)
Skin, soft tissue or joint 0.95 (0.83-1.09) 0.64 (0.21-1.96)
Gram negative 0.96 (0.81-1.13) 1.24 (0.56-2.76)
Gram positive (staphylococcus or streptococcus)
1.28 (1.01-1.62) 1.26 (0.59-2.69) Other unspecified bacteria 0.92 (0.84-1.01) 1.00 (0.47-2.15)
Tuberculosis or fungus 1.10 (0.91-1.34) n/a
Virus 0.95 (0.81-1.12) n/a
Inpatient medications
Any Vasopressor 1.20 (1.02-1.40) 1.12 (0.78-1.63)
Anticoagulant 1.88 (1.69-2.10) 2.06 (1.64-2.58)
Anti-platelet/aspirin 1.69 (1.55-1.85) 1.68 (1.35-2.08)
Corticosteroid 1.06 (0.96-1.18) 0.95 (0.77-1.19)
Statin 1.00 (0.90-1.11) 0.91 (0.73-1.14)
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eFigure 1a. Calibration plots Kaiser Permanente Northern California-derived models predicting post-sepsis cardiovascular events within Kaiser Permanente Northern California healthcare system. X-axis is predicted event rate and y-axis is the observed event rates, with grey line as line of perfect calibration where observed and predicted event rates are identical. Blue lines represent models that contain sets of pre-and intra- sepsis variables, orange lines from models that contain only intra-sepsis variables, and black lines from models with only pre-sepsis variables.
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eFigure 1b. Distribution of predicted risk for cardiovascular outcomes in Kaiser Permanente Northern California data
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eFigure 2a. Calibration plots Intermountain Healthcare models predicting post-sepsis cardiovascular events within Intermountain Healthcare system. X-axis is predicted event rate and y-axis is the observed event rates, with grey line as line of perfect calibration where observed and predicted event rates are identical. Blue lines represent models that contain sets of pre-and intra-sepsis variables, orange lines from models that contain only intra-sepsis variables, and black lines from models with only pre-sepsis variables.
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eFigure 2b. Distribution of predicted risk for cardiovascular outcomes in Intermountain healthcare.
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eFigure 3. Calibration plots of Intermountain Healthcare models predicting post-sepsis cardiovascular events externally validated within data from sepsis survivors at Kaiser Permanente Northern California.
X-axis is predicted event rate and y-axis is the observed event rates, with grey line as line of perfect calibration where observed and predicted event rates are identical. Blue lines represent models that contain sets of pre-and intra-sepsis variables, orange lines from models that contain only intra-sepsis variables, and black lines from models with only pre-sepsis variables.
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eFigure 4. Calibration plots of Kaiser Permanente Northern California models predicting post-sepsis cardiovascular events externally validated within data from sepsis survivors at Intermountain Healthcare.
X-axis is predicted event rate and y-axis is the observed event rates, with grey line as line of perfect calibration where observed and predicted event rates are identical. Blue lines represent models that contain sets of pre-and intra-sepsis variables, orange lines from models that contain only intra-sepsis variables, and black lines from models with only pre-sepsis variables.
