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Table 2 Multivariable linear regression analyses determining significant and independent associations between risk factors and the change in leukocyte telomere length from admission to the last day in PICU

From: Leukocyte telomere length in paediatric critical illness: effect of early parenteral nutrition

 

A

B

C

Variable

Estimate (95% CI) for change in telomere length expressed as T/S units, adjusted for risk factors

P value

Estimate (95% CI) for change in telomere length expressed as T/S units, adjusted for risk factors, including duration of PICU stay

P value

Estimate (95% CI) for change in telomere length expressed as T/S units, adjusted for risk factors, including cumulative dose of insulin and acquisition of new infection during PICU stay

P value

Randomisation to early vs. late initiation of PN

−0.021 (−0.038; –0.004)

0.01

−0.020 (−0.037;–0.003)

0.01

−0.018 (−0.035; –0.0001)

0.04

Change in fraction of neutrophils from admission to the last day (per % added)a

−0.106 (−0.165; –0.048)

0.0004

− 0.115 (−0.174; –0.056)

0.002

−0.103 (−0.162; –0.044)

0.0006

Age (per year added)

−0.073 (−0.112; –0.034)

0.0003

−0.075 (−0.114; –0.037)

0.0002

−0.075 (−0.114; –0.036)

0.0002

Male vs. female sex

−0.017 (−0.034; 0.000)

0.05

−0.016 (−0.033; 0.001)

0.06

−0.016 (−0.033; 0.000)

0.05

Leukocyte telomere length upon admission (per T/S unit added)

−0.290 (− 0.356; –0.224)

< 0.0001

−0.290 (−0.356; –0.225)

< 0.0001

−0.288 (− 0.353; –0.222)

< 0.0001

Diagnostic category (as compared with all other categories)

 Surgical

  Abdominal

0.138 (0.022; 0.253)

0.01

0.135 (0.019; 0.250)

0.02

0.135 (0.019; 0.250)

0.02

  Cardiac

−0.012 (−0.059; 0.036)

0.63

−0.016 (−0.065; 0.032)

0.50

−0.009 (−0.057; 0.039)

0.71

  Neurosurgery-traumatic brain injury

−0.025 (−0.092; 0.042)

0.45

−0.021 (−0.088; 0.046)

0.54

−0.023 (−0.090; 0.045)

0.51

  Thoracic

0.008 (−0.073; 0.088)

0.85

0.007 (−0.073; 0.087)

0.86

0.004 (−0.077; 0.084)

0.93

  Transplantation

−0.051 (−0.211; 0.109)

0.53

−0.060 (−0.220; 0.100)

0.45

−0.055 (−0.215; 0.105)

0.49

  Orthopaedic surgery-trauma

0.022 (−0.062; 0.106)

0.60

0.026 (−0.058; 0.109)

0.54

0.029 (−0.055; 0.113)

0.50

  Other

0.091 (−0.019; 0.202)

0.10

0.090 (−0.020; 0.201)

0.10

0.094 (−0.016; 0.205)

0.09

 Medical

      

  Cardiac

−0.048 (−0.185; 0.089)

0.49

−0.050 (−0.187; 0.087)

0.47

−0.040 (−0.178; 0.097)

0.56

  Gastrointestinal-hepatic

−0.091 (−0.294; 0.112)

0.37

−0.098 (−0.300; 0.104)

0.34

−0.088 (−0.291; 0.114)

0.39

  Neurologic

−0.012 (−0.091; 0.067)

0.76

−0.016 (−0.095; 0.063)

0.69

−0.017 (−0.096; 0.063)

0.67

  Respiratory

−0.014 (−0.113; 0.085)

0.78

−0.011 (−0.110; 0.088)

0.82

−0.024 (−0.123; 0.076)

0.64

  Other

−0.006 (−0.116; 0.105)

0.91

0.015 (−0.097; 0.127)

0.79

−0.006 (−0.116; 0.105)

0.92

PeLOD score first 24 h (per point added)b

−0.020 (−0.069; 0.028)

0.40

−0.015 (−0.064; 0.034)

0.54

−0.019 (−0.068; 0.030)

0.44

PIM2 score (per point added)c,d

0.031 (−0.048; 0.111)

0.44

0.048 (−0.033; 0.128)

0.24

0.038 (−0.043; 0.120)

0.35

High vs. medium STRONGkids risk levele

−0.015 (−0.052; 0.022)

0.42

0.013 (−0.024; 0.050)

0.49

0.013 (−0.024; 0.051)

0.47

Infection vs. no infection upon-admission

−0.009 (−0.033; 0.015)

0.46

−0.004 (−0.029; 0.021)

0.74

−0.004 (−0.029; 0.021)

0.76

Centre (Leuven vs. Rotterdam)

0.084 (−0.030; 0.198)

0.14

0.090 (−0.024; 0.204)

0.12

0.087 (−0.027; 0.201)

0.13

Height (per percentile of population norms added)f

0.006 (−0.029; 0.041)

0.72

0.005 (−0.030; 0.039)

0.79

0.005 (−0.029; 0.040)

0.76

Weight (per percentile of population norms added)f

0.005 (−0.032; 0.042)

0.79

0.006 (−0.031; 0.043)

0.75

0.007 (−0.030; 0.044)

0.72

Chronicity vs. no chronicityg

0.020 (−0.009; 0.050)

0.17

0.025 (−0.054; 0.005)

0.09

0.021 (−0.008; 0.051)

0.15

Duration of stay in the PICU (per day added)

  

−0.144 (−0.284; –0.004)

0.04

  

Cumulative dose of insulin (per IU/kg added)

    

−0.091 (−0.198; 0.017)

0.09

New infection vs. no new infection

    

0.024 (−0.012; 0.059)

0.19

  1. Abbreviations: PeLOD Paediatric Logistic Organ Dysfunction, PIM2 Paediatric Index of Mortality 2, PICU paediatric ICU, T/S telomere/single-gene-copy ratio, STRONGkids, Screening Tool for Risk on Nutritional Status and Growth, IU international units
  2. Independent determinants of change in telomere length are indicated in italics
  3. aThe fraction of neutrophils is the percentage neutrophils of the total leukocyte count, ranging from 0 to 100%.
  4. Analyses were performed in 508 patients for whom all variables were available
  5. bPeLOD scores range from 0 to 71, with higher scores indicating more severe illness
  6. cPIM2 scores, with higher scores indicating a higher risk of mortality
  7. dIncluding the PIM2 probabilities of death (ranging from 0% to 100%, with higher percentages indicating a higher probability of death in PICU) instead of the PIM2 scores, did not change any of the results. Per % added, the estimate expressed as T/S units (95% CI) for PIM2 probability of death, was 0.0002 (−0.0005; 0.0009), P = 0.63. In the model adjusted for duration of stay in the PICU, the estimate expressed as T/S units (95% CI) per % PIM2 probability of death added was 0.0003 (−0.0004; 0.001), P = 0.41
  8. eScores on the STRONGkids range from 0 to 5, with a score of 0 indicating a low risk of malnutrition, a score of 1–3 indicating medium risk, and a score of 4–5 indicating high risk
  9. fHeight and weight, expressed as percentiles of population norms, were calculated with the anthropometric calculators for normal children, based on the World Health Organisation Growth Charts for Canada (version 2015/02/24), and for children with syndromes known to affect height and weight (version 2014/09/25)
  10. gDichotomising label indicating whether or not the patient was suffering from any symptomatic chronic disease identified through screening of the patient’s medical history and hospital files
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Critical Care

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