Predicting outcomes in patients with sepsis-associated encephalopathy using prefrontal functional connectivity analysis

Figures

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  Fig. 1. Visualization of the fNIRS system on the forehead and source-detector array with channel positions.

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  Fig. 2. Receiver operating characteristic curves depicting the prediction of outcomes following SAE. This plot demonstrates the correlation between sensitivity (Y-axis) and the reciprocal of specificity (X-axis), highlighting the highest area under the curve (AUC) for Acute Physiology and Chronic Health Evaluation (APACHE) III with a density of 0.6 and a composite of APACHE III with a density of 0.6. The use of both APACHE III and density at 0.6 resulted in the highest AUC value (0.951 [0.893–1.000]), outperforming AUC values obtained when using APACHE III alone (0.857 [0.735–0.979]) or density at 0.6 alone (0.716 [0.557–0.876]). (A) Notable variances observed between the combined approach and each individual predictor (APACHE III with density at 0.6 vs. density of 0.6, P = 0.04; APACHE III with density vs. APACHE III, P = 0.09); (B) Cutoff values of predictive methods with sensitivity and specificity.

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  Fig. 3. Three-dimensional mesh plot of the prediction method. Correlation between Acute Physiology and Chronic Health Evaluation (APACHE) III and connectivity density (threshold = 0.6) with outcomes after sepsis-associated encephalopathy (SAE). Visualization was performed after SAE in patients with an average age of 70.8 years (n = 40); 17 patients had good outcomes after SAE. Discretely color-coded mesh (blue to orange) representing Glasgow Coma Scale scores from 0 to 15 correlated with the connectivity density threshold at 0.6 and APACHE III score (Y-axis) using natural neighbor interpolation. Acquired data points are represented by red and blue square dots, indicating poor (n = 23) and good (n = 17) outcomes, respectively. Higher APACHE III scores and lower connectivity densities were associated with poorer outcomes. Although the APACHE III score increased, a higher connectivity density value of the connectivity analysis was associated with a good outcome.