Clinical phenotypes of sepsis: a narrative review

Abstract

Background and objective: Sepsis, characterized by an aberrant immune response to infection leading to acute organ dysfunction, impacts millions of individuals each year and carries a substantial risk of mortality, even with prompt care. Despite notable medical advancements, managing sepsis remains a formidable challenge for clinicians and researchers, with treatment options limited to antibiotics, fluid therapy, and organ-supportive measures. Given the heterogeneous nature of sepsis, the identification of distinct clinical phenotypes holds the promise of more precise therapy and enhanced patient care. In this review, we explore various phenotyping schemes applied to sepsis.

Methods: We searched PubMed with the terms "Clinical phenotypes AND sepsis" for any type of article published in English up to September 2023. Only reports in English were included, editorials or articles lacking full text were excluded. A review of clinical phenotypes of sepsis is provided.

Key content and findings: While discerning clinical phenotypes may seem daunting, the application of artificial intelligence and machine learning techniques provides a viable approach to quantifying similarities among individuals within a sepsis population. These methods enable the differentiation of individuals into distinct phenotypes based on not only factors such as infectious diseases, infection sites, pathogens, body temperature changes and hemodynamics, but also conventional clinical data and molecular omics.

Conclusions: The classification of sepsis holds immense significance in improving clinical cure rates, reducing mortality, and alleviating the economic burden associated with this condition.

Keywords: Sepsis; heterogeneity; phenotype.