ArticleCritical care (London, England)2021
A hypolipoprotein sepsis phenotype indicates reduced lipoprotein antioxidant capacity, increased endothelial dysfunction and organ failure, and worse clinical outcomes.
Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- The Effect of Cranberry Consumption on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Clinical cardiology · 2026Pooled it
- Risk factors, biomarkers, and mechanisms for persistent inflammation, immunosuppression, and catabolism syndrome (PICS): a systematic review and meta-analysis.British journal of anaesthesia · 2024Pooled it
- Deciphering sepsis molecular subtypes using large-scale data to identify subtype-specific drug repurposing.bioRxiv : the preprint server for biology · 2026Article
- Admission lipid profile and outcomes in sepsis requiring early invasive source control.BMC infectious diseases · 2026Observational
- Metabolic phenotyping of sepsis in large multicenter cohorts: identification of a reproducible high-risk subgroup.Lipids in health and disease · 2026Article
- Association of the atherogenic index of plasma with in-hospital mortality in patients with sepsis-induced coagulopathy.Lipids in health and disease · 2025Article
- Risk factors associated with return sepsis admission following emergency department discharge with infection.The American journal of emergency medicine · 2025Article
- Definitions, epidemiology, and outcomes of persistent/chronic critical illness: a scoping review for translation to clinical practice.Critical care (London, England) · 2024Article
- Multiomic molecular patterns of lipid dysregulation in a subphenotype of sepsis with higher shock incidence and mortality.Critical care (London, England) · 2024Article
- The Tri-Steps Model of Critical Conditions in Intensive Care: Introducing a New Paradigm for Chronic Critical Illness.Journal of clinical medicine · 2024Article
- Clinical correlates of circulating small dense low-density lipoproteins in acute infective endocarditis.Infection · 2024Article
- Lipidomic changes in a novel sepsis outcome-based analysis reveals potent pro-inflammatory and pro-resolving signaling lipids.Clinical and translational science · 2024Article
- TRENDS IN CHOLESTEROL AND LIPOPROTEINS ARE ASSOCIATED WITH ACUTE RESPIRATORY DISTRESS SYNDROME INCIDENCE AND DEATH AMONG SEPSIS PATIENTS.Shock (Augusta, Ga.) · 2024Article
- An interpretable machine learning model for predicting 28-day mortality in patients with sepsis-associated liver injury.PloS one · 2024Article
- Apolipoprotein A-I: Potential Protection Against Intestinal Injury Induced by Dietary Lipid.Journal of inflammation research · 2024Review
- Sepsis-induced Coagulopathy Subphenotype Identification by Latent Class AnalysisBalkan medical journal · 2023Article
- Association Between Hypocholesterolemia and Mortality in Critically Ill Patients With Sepsis: A Systematic Review and Meta-Analysis.Critical care explorations · 2023Review
- DHCR7 Expression Predicts Poor Outcomes and Mortality from Sepsis.Research square · 2023Article
- The critical role of neutrophil-endothelial cell interactions in sepsis: new synergistic approaches employing organ-on-chip, omics, immune cell phenotyping andFrontiers in cellular and infection microbiology · 2023Review
- Genetic association of lipids and lipid-lowering drugs with sepsis: a Mendelian randomization and mediation analysis.Frontiers in cardiovascular medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveApproximately one-third of sepsis patients experience poor outcomes including chronic critical illness (CCI, intensive care unit (ICU) stay > 14 days) or early death (in-hospital death within 14 days). We sought to characterize lipoprotein predictive ability for poor outcomes and contribution to sepsis heterogeneity.
designProspective cohort study with independent replication cohort.
settingEmergency department and surgical ICU at two hospitals. PATIENTS: Sepsis patients presenting within 24 h.
methodsMeasures included cholesterol levels (total cholesterol, high density lipoprotein cholesterol [HDL-C], low density lipoprotein cholesterol [LDL-C]), triglycerides, paraoxonase-1 (PON-1), and apolipoprotein A-I (Apo A-I) in the first 24 h. Inflammatory and endothelial markers, and sequential organ failure assessment (SOFA) scores were also measured. LASSO selection assessed predictive ability for outcomes. Unsupervised clustering was used to investigate the contribution of lipid variation to sepsis heterogeneity. MEASUREMENTS AND MAIN
results172 patients were enrolled. Most (~ 67%, 114/172) rapidly recovered, while ~ 23% (41/172) developed CCI, and ~ 10% (17/172) had early death. ApoA-I, LDL-C, mechanical ventilation, vasopressor use, and Charlson Comorbidity Score were significant predictors of CCI/early death in LASSO models. Unsupervised clustering yielded two discernible phenotypes. The Hypolipoprotein phenotype was characterized by lower lipoprotein levels, increased endothelial dysfunction (ICAM-1), higher SOFA scores, and worse clinical outcomes (45% rapid recovery, 40% CCI, 16% early death; 28-day mortality, 21%). The Normolipoprotein cluster patients had higher cholesterol levels, less endothelial dysfunction, lower SOFA scores and better outcomes (79% rapid recovery, 15% CCI, 6% early death; 28-day mortality, 15%). Phenotypes were validated in an independent replication cohort (N = 86) with greater sepsis severity, which similarly demonstrated lower HDL-C, ApoA-I, and higher ICAM-1 in the Hypolipoprotein cluster and worse outcomes (46% rapid recovery, 23% CCI, 31% early death; 28-day mortality, 42%). Normolipoprotein patients in the replication cohort had better outcomes (55% rapid recovery, 32% CCI, 13% early death; 28-day mortality, 28%) Top features for cluster discrimination were HDL-C, ApoA-I, total SOFA score, total cholesterol level, and ICAM-1.
conclusionsLipoproteins predicted poor sepsis outcomes. A Hypolipoprotein sepsis phenotype was identified and characterized by lower lipoprotein levels, increased endothelial dysfunction (ICAM-1) and organ failure, and worse clinical outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.