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Related Experiment Video

Updated: Jun 14, 2025

A Data-Driven Approach to Quantifying Immune States in Sepsis
07:42

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Published on: February 7, 2025

150

Novel cortisol trajectory sub-phenotypes in sepsis.

Fei Leng1, Zhunyong Gu1, Simeng Pan1

  • 1Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.

Critical Care (London, England)
|September 3, 2024
PubMed
Summary
This summary is machine-generated.

This study identified two distinct sepsis sub-phenotypes based on plasma cortisol levels. The higher-cortisol group showed significantly increased 28-day and 90-day mortality rates, highlighting a novel approach to sepsis classification.

Keywords:
CortisolMortalitySepsisSub-phenotypeTrajectory

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Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Genomics

Background:

  • Sepsis is a complex and heterogeneous condition with varying clinical presentations.
  • Understanding sepsis heterogeneity is crucial for developing targeted treatment strategies.
  • Plasma cortisol levels can fluctuate during sepsis and may indicate different disease trajectories.

Purpose of the Study:

  • To identify novel sepsis sub-phenotypes using plasma cortisol trajectories.
  • To investigate the association between identified cortisol sub-phenotypes and patient outcomes.
  • To provide new insights into the classification and understanding of sepsis.

Main Methods:

  • Retrospective study of 258 sepsis patients admitted to the ICU.
  • Application of a group-based cortisol trajectory model to classify patients.
  • Comparison of clinical characteristics, biomarkers, and mortality between sub-phenotypes.

Main Results:

  • Two distinct cortisol trajectory sub-phenotypes were identified: a lower-cortisol group and a higher-cortisol group.
  • The higher-cortisol group exhibited significantly higher 28-day (65.9% vs. 16.1%) and 90-day (65.9% vs. 19.8%) mortality.
  • Cortisol trajectory sub-phenotype, APACHE II, SOFA, and IL-1β were independent risk factors for mortality.

Conclusions:

  • Two novel cortisol trajectory sub-phenotypes in sepsis patients were identified.
  • These sub-phenotypes are significantly associated with differential mortality risks.
  • Cortisol trajectory analysis offers a promising new dimension for sepsis classification and prognostication.