Defining critical illness using immunological endotypes in patients with and without sepsis: a cohort study
Authors' conclusion
Critically ill surgical patients express different and evolving immunological endotypes depending upon both their sepsis status and severity of their clinical course.
Study context
- Population
- Patients admitted to surgical intensive care unit (ICUs) over a 5-year period ending in July 2020
- Participants
- 522 patients · 2 cohorts
- Exposure
- Septic vs Non-septic
- Outcome
- Immunological endotypes (33-mRNA classifier) and predicted 30-day mortality (IMX-SEV-3)
Methodological detailssingle-site, two cohorts
- Single-site
- Two cohorts
Main finding
As reported in the abstract
- Endotypes changed during ICU hospitalization
- 57.5%
- Sepsis with high predicted mortality: inflammopathic endotype
- 49.6%
- Sepsis with high predicted mortality: cumulative adverse outcomes
- 67.4%
- Low mortality risk, septic: adaptive endotype
- 100%
- Low mortality risk, non-septic: adaptive endotype
- 93.4%
Observational data: associations, not effects.
Further findings
Secondary infections by endotype
- Significantly higher in inflammopathic and coagulopathic septic and inflammopathic non-septic patients vs adaptive endotypes
- P < 0.01
Original publication
Defining critical illness using immunological endotypes in patients with and without sepsis: a cohort study. Crit Care. Published 20 July 2023. doi:10.
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