Novel cortisol trajectory sub-phenotypes in sepsis
Authors' conclusion
This study identified two novel cortisol trajectory sub-phenotypes in patients with sepsis. The trajectories were associated with mortality, providing new insights into sepsis classification.
Study context
- Population
- Patients with sepsis admitted to the ICU of Zhongshan Hospital Fudan University, March 2020–July 2022186 male
- Participants
- 258 patients
- Exposure
- Higher-cortisol vs lower-cortisol trajectory sub-phenotype
- Higher-cortisoln = 41
- Lower-cortisoln = 217reference
- Outcome
- Cortisol trajectory sub-phenotypes and their association with mortality
Methodological detailssingle-centre, group-based trajectory modelling
- Single-centre
- Group-based trajectory modelling
Main finding
As reported in the abstract
28-day mortality · 28 days
Hazard ratio (95% CI)P value
Trajectory sub-phenotype
5.292(2.218–12.626)
P < 0.001APACHE II
1.109(1.030–1.193)
P = 0.006SOFA
1.161(1.045–1.291)
P = 0.006IL-1β
1.001(1.000–1.002)
P = 0.007Observational data: associations, not effects.
Further findings
90-day mortality
| HR (95% CI) | P value | ||
|---|---|---|---|
| Trajectory sub-phenotypeMultivariable Cox regression; independent risk factor | 4.571 (1.980–10.551) | P < 0.001 | |
| APACHE IIMultivariable Cox regression; independent risk factor | 1.108 (1.043–1.177) | P = 0.001 | |
| SOFAMultivariable Cox regression; independent risk factor | 1.270 (1.130–1.428) | P < 0.001 | |
| IL-1βMultivariable Cox regression; independent risk factor | 1.001 (1.000–1.001) | P = 0.015 | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | Lower-cortisol | P value |
|---|---|---|
| 90-day mortality · 90 daysHigher-cortisol vs Lower-cortisol | 19.8% | P < 0.001 |
Original publication
Novel cortisol trajectory sub-phenotypes in sepsis. Crit Care. Published 3 September 2024. doi:10.
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