ArticleIntensive care medicine2022
Source-specific host response and outcomes in critically ill patients with sepsis: a prospective cohort study.
Article in Intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Peripheral adaptive immune cell counts and mortality in adult sepsis: a systematic review and meta-analysis.Frontiers in immunology · 2026Pooled it
- Clinical and biochemical endpoints and predictors of response to plasma exchange in septic shock: results from a randomized controlled trial.Critical care (London, England) · 2022Trial
- Vasopressor Use Among Adults With Sepsis in Uganda and Rwanda: A Multicenter Retrospective Cohort Study.Critical care explorations · 2026Article
- Review
- Source control within 12 h attenuates lung injury and systemic bacterial burden in a rat model of polymicrobial abdominal sepsis (cecal ligation and puncture).Intensive care medicine experimental · 2026Article
- Service-Specific Heterogeneity in Sepsis Variable Significance and Machine Learning Model Performance: A Stratified Analysis of the BIAlert Cohort.Journal of clinical medicine · 2026Article
- Integrating host mRNA signatures and clinical trajectories with machine learning for risk stratification and survival prediction in sepsis: an ICU-based prospective cohort study.BMC infectious diseases · 2026Article
- Machine-learning algorithms identifies sTREM1 has a key biomarker for outcome prediction in critically ill.Critical care (London, England) · 2026Observational
- Machine learning prediction of in-hospital mortality risk among hospitalized patients with secondary bloodstream infection: a retrospective cohort study.BMC infectious diseases · 2026Article
- Data-driven spatial-temporal framework for exploring the heterogeneity and temporality of sepsis.Chinese medical journal · 2026Review
- Pathological networks and multi-target interventions in sepsis-associated acute lung injury: from pathogen-host interactions to gut-lung axis regulation.Frontiers in immunology · 2026Review
- Endothelial glycocalyx injury in bacterial bloodstream infection: biological determinants and association with host response aberrations.Frontiers in cellular and infection microbiology · 2026Article
- Single-cell multi-omic landscape reveals anatomical-specific immune features in adult and pediatric sepsis.Nature immunology · 2026Article
- The high-risk phenotype for gastrointestinal vulnerability in sepsis and 28-day mortality: an integrative study based on clinical association and cross-level biological support.Frontiers in medicine · 2026Article
- Angiopoietin-2 Surpasses Soluble Thrombomodulin and Syndecan-1 in Characterizing Septic Shock and Predicting Mortality--A Prospective Observational Study.Journal of inflammation research · 2026Article
- Enhanced insights into immunity traits of elderly patients in the intensive care unit with infections: evidence from a multicenter, prospective observational study.Critical care (London, England) · 2025Observational
- Crosstalk between lung and extrapulmonary organs in sepsis-related acute lung injury/acute respiratory distress syndrome.Annals of intensive care · 2025Review
- Association of Causative Pathogens With Acute Kidney Injury in Adult Patients With Community-Onset Sepsis.Critical care explorations · 2025Article
- Impact of Early Albumin Use for Resuscitation in Patients With Septic Shock and Cirrhosis.Canadian journal of gastroenterology & hepatology · 2025Article
- Considering local immunity for innovative immunomodulatory approaches: pulmonary sepsis as a use case.Frontiers in immunology · 2025Review
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
Abstract
purposeThere is limited knowledge on how the source of infection impacts the host response to sepsis. We aimed to compare the host response in sepsis patients with a single, known source at admission (< 24 h) to the intensive care unit.
methodsFrom the molecular diagnosis and risk stratification of sepsis (MARS) prospective cohort, we measured 16 plasma host response biomarkers reflective of key host response pathways in 621 sepsis patients. In a subgroup (n = 335), blood leukocyte transcriptomes were compared between the sources. Differences in clinical patient profiles and survival were compared in the whole sepsis cohort (n = 2019).
resultsThe plasma biomarker cohort was categorized into sepsis originating from the respiratory tract (n = 334, 53.8%), abdomen (n = 159, 25.6%), urinary tract (n = 44, 7.1%), cardiovascular (n = 41, 6.6%), central nervous system (CNS) (n = 18, 2.9%), or skin (n = 25, 4%). This analysis revealed stronger inflammatory and cytokine responses, loss of vascular integrity and coagulation activation in abdominal sepsis relative to respiratory. Endothelial cell activation was prominent in urinary, cardiovascular and skin infections, while CNS infection was associated with the least host response aberrations. The leukocyte transcriptional response showed the largest overlap between abdominal and pulmonary infections (76% in common); notable differences between the sources were detected regarding hemostasis, cytokine signaling, innate and adaptive immune, and metabolic transcriptional pathways. After adjustment for confounders, the source of infection remained an independent contributor to 30-day mortality (unadjusted p = 0.001, adjusted p = 0.028).
conclusionSepsis heterogeneity is partly explained by source-specific host response dysregulations and should be considered when selecting patients for trials testing immune modulatory drugs.
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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.