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Critical Care
Published in: Critical Care 1/2022

01-12-2022 | Septicemia | Research

Identifying clinical subtypes in sepsis-survivors with different one-year outcomes: a secondary latent class analysis of the FROG-ICU cohort

Authors: Sabri Soussi, Divya Sharma, Peter Jüni, Gerald Lebovic, Laurent Brochard, John C. Marshall, Patrick R. Lawler, Margaret Herridge, Niall Ferguson, Lorenzo Del Sorbo, Elodie Feliot, Alexandre Mebazaa, Erica Acton, Jason N. Kennedy, Wei Xu, Etienne Gayat, Claudia C. Dos Santos, the FROG-ICU, CCCTBG trans-trial group study for InFACT - the International Forum for Acute Care Trialists

Published in: Critical Care | Issue 1/2022

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Abstract

Background

Late mortality risk in sepsis-survivors persists for years with high readmission rates and low quality of life. The present study seeks to link the clinical sepsis-survivors heterogeneity with distinct biological profiles at ICU discharge and late adverse events using an unsupervised analysis.

Methods

In the original FROG-ICU prospective, observational, multicenter study, intensive care unit (ICU) patients with sepsis on admission (Sepsis-3) were identified (N = 655). Among them, 467 were discharged alive from the ICU and included in the current study. Latent class analysis was applied to identify distinct sepsis-survivors clinical classes using readily available data at ICU discharge. The primary endpoint was one-year mortality after ICU discharge.

Results

At ICU discharge, two distinct subtypes were identified (A and B) using 15 readily available clinical and biological variables. Patients assigned to subtype B (48% of the studied population) had more impaired cardiovascular and kidney functions, hematological disorders and inflammation at ICU discharge than subtype A. Sepsis-survivors in subtype B had significantly higher one-year mortality compared to subtype A (respectively, 34% vs 16%, p < 0.001). When adjusted for standard long-term risk factors (e.g., age, comorbidities, severity of illness, renal function and duration of ICU stay), subtype B was independently associated with increased one-year mortality (adjusted hazard ratio (HR) = 1.74 (95% CI 1.16–2.60); p = 0.006).

Conclusions

A subtype with sustained organ failure and inflammation at ICU discharge can be identified from routine clinical and laboratory data and is independently associated with poor long-term outcome in sepsis-survivors.

Graphical Abstract

Appendix
Available only for authorised users
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Metadata
Title
Identifying clinical subtypes in sepsis-survivors with different one-year outcomes: a secondary latent class analysis of the FROG-ICU cohort
Authors
Sabri Soussi
Divya Sharma
Peter Jüni
Gerald Lebovic
Laurent Brochard
John C. Marshall
Patrick R. Lawler
Margaret Herridge
Niall Ferguson
Lorenzo Del Sorbo
Elodie Feliot
Alexandre Mebazaa
Erica Acton
Jason N. Kennedy
Wei Xu
Etienne Gayat
Claudia C. Dos Santos
the FROG-ICU
CCCTBG trans-trial group study for InFACT - the International Forum for Acute Care Trialists
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2022
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-022-03972-8

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