ArticleMilitary Medical Research2021
Association of fluid balance trajectories with clinical outcomes in patients with septic shock: a prospective multicenter cohort study.
Article in Military Medical Research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Fluid balance and mortality in adult ICU patients with sepsis or septic shock: a systematic review and meta-analysis of observational studies.BMC anesthesiology · 2025Pooled it
- Continuous renal replacement therapy attenuates endothelial injury biomarkers in pediatric sepsis: a prospective cohort study.Renal failure · 2026Observational
- How glycemic variability trajectories impact clinical outcomes in critically ill patients with severe pneumonia: a prospective cohort study.BMC anesthesiology · 2026Article
- Group-based trajectory modeling of blood pressure reactivity and mortality in septic patients: a retrospective study of the MIMIC-IV database.BMC infectious diseases · 2026Article
- Time-Dependent Fluid Accumulation Index for Phase-Specific Risk Stratification in Septic Shock with Heart Failure.Current medical science · 2026Article
- Association of active fluid de-escalation timing with clinical outcomes in patients with septic shock: a multicenter cohort study.BMC infectious diseases · 2026Article
- Association of fluid balance trajectories and cumulative fluid balance with in-hospital mortality in patients with acute pancreatitis.Frontiers in medicine · 2026Article
- Joint trajectories of nutritional risk and fluid balance and prognosis in critically ill adults: a dual-trajectory modeling study using MIMIC-IV and eICU.Frontiers in nutrition · 2026Article
- Clinical subphenotypes and molecular endotypes in sepsis: toward an integrated and dynamic framework.Annals of intensive care · 2026Review
- Association between fluid balance trajectories and prognosis in older patients with malnutrition: a group-based trajectory model analysis.Frontiers in nutrition · 2026Article
- Association of hemoglobin level trajectories with clinical outcomes in patients with sepsis or shock: a retrospective observational study.BMC infectious diseases · 2025Observational
- The association between fluid balance trajectories and prognosis in ICU patients with cardiac arrest, a group-based trajectory model analysis.Frontiers in nutrition · 2025Article
- High NE dose trajectory is associated with new onset of acute kidney injury patients: A group-based trajectory modeling analysis.PloS one · 2025Article
- Intra-abdominal sepsis in critically ill surgical patients: the relationship between cumulative fluid balance and serum sodium and chloride levels and in-hospital mortality.Frontiers in medicine · 2025Article
- Article
- Identification of novel phenotypes in pediatric sepsis based on blood glucose trajectories.Frontiers in pediatrics · 2025Article
- Fluid balance trajectories and prognosis in patients with acute myocardial infarction complicated by cardiogenic shock: a group-based trajectory model approach.Frontiers in cardiovascular medicine · 2025Article
- Cardiac Surgery-Specific Subtle Perioperative Serum Creatinine Change in Defining Acute Kidney Injury After Coronary Surgery.JACC. Advances · 2024Article
- The value of circadian heart rate variability for the estimation of obstructive sleep apnea severity in adult males.Sleep & breathing = Schlaf & Atmung · 2024Article
- Identifying novel clinical phenotypes of acute respiratory distress syndrome using trajectories of daily fluid balance: a secondary analysis of randomized controlled trials.European journal of medical research · 2024Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeptic shock has a high incidence and mortality rate in Intensive Care Units (ICUs). Earlier intravenous fluid resuscitation can significantly improve outcomes in septic patients but easily leads to fluid overload (FO), which is associated with poor clinical outcomes. A single point value of fluid cannot provide enough fluid information. The aim of this study was to investigate the impact of fluid balance (FB) latent trajectories on clinical outcomes in septic patients.
methodsPatients were diagnosed with septic shock during the first 48 h, and sequential fluid data for the first 3 days of ICU admission were included. A group-based trajectory model (GBTM) which is designed to identify groups of individuals following similar developmental trajectories was used to identify latent subgroups of individuals following a similar progression of FB. The primary outcomes were hospital mortality, organ dysfunction, major adverse kidney events (MAKE) and severe respiratory adverse events (SRAE). We used multivariable Cox or logistic regression analysis to assess the association between FB trajectories and clinical outcomes.
resultsNine hundred eighty-six patients met the inclusion criteria and were assigned to GBTM analysis, and three latent FB trajectories were detected. 64 (6.5%), 841 (85.3%), and 81 (8.2%) patients were identified to have decreased, low, and high FB, respectively. Compared with low FB, high FB was associated with increased hospital mortality [hazard ratio (HR) 1.63, 95% confidence interval (CI) 1.22-2.17], organ dysfunction [odds ratio (OR) 2.18, 95% CI 1.22-3.42], MAKE (OR 1.80, 95% CI 1.04-2.63) and SRAE (OR 2.33, 95% CI 1.46-3.71), and decreasing FB was significantly associated with decreased MAKE (OR 0.46, 95% CI 0.29-0.79) after adjustment for potential covariates.
conclusionLatent subgroups of septic patients followed a similar FB progression. These latent fluid trajectories were associated with clinical outcomes. The decreasing FB trajectory was associated with a decreased risk of hospital mortality and MAKE.
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