ArticleCritical care (London, England)2022
A novel Vascular Leak Index identifies sepsis patients with a higher risk for in-hospital death and fluid accumulation.
Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Targeting capillary leak in experimental sepsis and endotoxemia: a systematic review of therapeutic agents, methods and models in animal studies.Critical care (London, England) · 2026Pooled it
- Impact of the updated SOFA-2 score on sepsis diagnosis and prognosis: a retrospective multicenter cohort study.Critical care (London, England) · 2026Observational
- Early Norepinephrine Attenuates Fluid-Associated Albumin Decline in Sepsis: A Prospective Longitudinal Study.Journal of clinical medicine · 2026Article
- Baseline Blood Eosinophil Count and 28-Day in-Hospital Mortality in ICU-Admitted Patients with AECOPD: A Cohort Study with External Validation.International journal of chronic obstructive pulmonary disease · 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
- Early prediction of vasopressor initiation in ICU sepsis patients using an interpretable EHR-based ML model.BMC medical informatics and decision making · 2025Article
- Platelet-mediated activation of perivascular mast cells triggers progression of sepsis to septic shock in mice.Nature communications · 2025Article
- The relationship between admission Braden score and poor prognosis in Sepsis patients: evidence from the MIMIC-III database.BMC infectious diseases · 2025Article
- Impact of in-hospital body mass index variation on 28-day mortality in critically ill surgical patients: a multi-center retrospective analysis.Frontiers in medicine · 2025Article
- Systemic capillary leak syndrome.Nature reviews. Disease primers · 2024Review
- Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study.BMC infectious diseases · 2024Article
- Association of body temperature and mortality in critically ill patients: an observational study using two large databases.European journal of medical research · 2024Observational
- Capillary leak and endothelial permeability in critically ill patients: a current overview.Intensive care medicine experimental · 2023Review
- The glycocalyx as a permeability barrier: basic science and clinical evidence.Critical care (London, England) · 2022Review
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Authors and funding
10 authors.
Funding
Abstract
purposeSepsis is a leading cause of morbidity and mortality worldwide and is characterized by vascular leak. Treatment for sepsis, specifically intravenous fluids, may worsen deterioration in the context of vascular leak. We therefore sought to quantify vascular leak in sepsis patients to guide fluid resuscitation.
methodsWe performed a retrospective cohort study of sepsis patients in four ICU databases in North America, Europe, and Asia. We developed an intuitive vascular leak index (VLI) and explored the relationship between VLI and in-hospital death and fluid balance using generalized additive models (GAM).
resultsUsing a GAM, we found that increased VLI is associated with an increased risk of in-hospital death. Patients with a VLI in the highest quartile (Q4), across the four datasets, had a 1.61-2.31 times increased odds of dying in the hospital compared to patients with a VLI in the lowest quartile (Q1). VLI Q2 and Q3 were also associated with increased odds of dying. The relationship between VLI, treated as a continuous variable, and in-hospital death and fluid balance was statistically significant in the three datasets with large sample sizes. Specifically, we observed that as VLI increased, there was increase in the risk for in-hospital death and 36-84 h fluid balance.
conclusionsOur VLI identifies groups of patients who may be at higher risk for in-hospital death or for fluid accumulation. This relationship persisted in models developed to control for severity of illness and chronic comorbidities.
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