A recent peer-reviewed study published in Cureus highlights the importance of clinical phenotyping in improving mortality prediction among critically ill adult patients with sepsis. The research demonstrates that simple, bedside-applicable clinical phenotypes can achieve prognostic accuracy comparable to established severity scoring systems.

Study Overview

This single-center retrospective cohort study evaluated 106 adult sepsis patients admitted to an intensive care unit (ICU) in Brazil between 2021 and 2023. Patients were classified using three distinct clinical phenotypic models:

Age and Body Temperature Profile (elderly with hypothermia vs. others)

Organ Dysfunction Phenotypes (multi-organ failure, respiratory, neurologic, or other)

Systolic Blood Pressure (SBP) Trajectories during the first 10 hours of ICU admission

The primary outcome assessed was in-hospital mortality, with comparisons made against standard prognostic tools such as SOFA and APACHE II scores.

Key Findings

Elderly patients with hypothermia had a significantly higher risk of in-hospital mortality
(Adjusted OR: 8.03; p = 0.007)

Multi-organ failure (MOF) was strongly associated with death
(Adjusted OR: 4.16; p = 0.014)

Persistent hypotension based on SBP trajectory did not independently predict mortality

Pneumonia was the most lethal infection source, increasing mortality risk more than 11-fold

Predictive Performance

A combined model integrating all three phenotypic classifications demonstrated strong predictive accuracy:

AUC: 0.856, outperforming

APACHE II (AUC: 0.776)

SOFA (AUC: 0.764)

This suggests that clinically intuitive phenotypes can match or exceed traditional scoring systems in high-severity ICU populations.

Clinical Implications

The study underscores the growing role of phenotype-driven precision medicine in sepsis care. Unlike biomarker-heavy or AI-dependent models, these phenotypes rely on readily available clinical data, making them practical for real-world ICU settings.

Conclusion

Simple clinical phenotyping—based on age, temperature, and organ dysfunction—offers a powerful and pragmatic approach to risk stratification in sepsis. These findings support further multicenter research to refine and standardize phenotype-based strategies for improving outcomes in critically ill patients.

Source: https://www.cureus.com/articles/455586-unmasking-heterogeneity-evaluating-distinct-sepsis-clinical-phenotypes-and-their-association-with-mortality-in-critical-adult-patients#!/