• Guanghao Liu, Ruoqiong Wu, Jun He, Yichang Xu, Li Han, Yingying Yu, Haibo Zhu, Yehan Guo, Hao Fu, Ting Chen, Shixiang Zheng, and Xiaopei Shen.
• School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350122, China; Fujian Key Laboratory of Medical Bioinformatics, Institute of Precision Medicine, Fujian Medical University, Fuzhou 350122, China; Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, Fuzhou 350122, China.
• J Crit Care. 2025 Feb 1; 85: 154932154932.

BackgroundSeptic shock (SS) is a highly fatal and heterogeneous syndrome. Identifying distinct clinical phenotypes provides valuable insights into the underlying pathophysiological mechanisms and may help to propose precise clinical management strategies.MethodsLatent profile analysis (LPA), a model-based unsupervised method, was used for phenotyping in the MIMIC cohort, and the model was externally independently validated in the eICU and AUMC cohorts.ResultsThree phenotypes, labeled phenotype I, II, and III, were derived. These phenotypes varied in demographics, clinical features, comorbidities, patterns of organ dysfunction, organ support, and prognosis. Phenotype I, characterized by the most severe organ dysfunction (especially liver), the youngest age, and the highest BMI, had the highest mortality (p < 0.001). Phenotype II, with moderate mortality, was characterized by severe renal injury. In contrast, phenotype III, associated with the oldest age and the fewest comorbidities, exhibited significantly lower mortality. Phenotype I patients had the steepest survival curves and demonstrated an ultra-high risk of death, particularly within the first few days after SS onset.ConclusionsThe individualized identification of phenotypes is well suited to clinical practice. The three SS phenotypes differed significantly in pathophysiological and clinical outcomes, which are crucial for informing management decisions and prognosis.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

18 keywords...

hide…