Clinical Report: Identifying a High-Risk Gastrointestinal Vulnerability Phenotype in Sepsis

Overview

This study identifies a gastrointestinal vulnerability phenotype (GIVP) in sepsis. The GIVP high-risk phenotype is associated with 28-day mortality.

Background

Gastrointestinal dysfunction is prevalent in sepsis but is often overlooked in risk stratification frameworks. This study aims to recognize gastrointestinal factors that contribute to mortality in sepsis.

Data Highlights

Key Findings

• The GIVP high-risk phenotype is associated with increased 28-day mortality in sepsis patients.
• In the primary analysis cohort, 6,862 out of 28,224 ICU admission events resulted in 28-day mortality.
• Incremental prediction analysis showed minimal discrimination improvement across the full cohort.
• External validation in the eICU-CRD supported the prognostic directionality of the GIVP phenotype.
• Cross-level analyses indicated a correlation with an interferon-high host-response pattern.

Clinical Implications

Clinicians should consider the GIVP high-risk phenotype when assessing sepsis patients, especially in higher-severity cases. Incorporating gastrointestinal factors into risk stratification may improve prognostic assessments and inform clinical decision-making.

Conclusion

The GIVP high-risk phenotype retains a prognostic association with 28-day mortality in sepsis.

Related Resources & Content

1. Critical Care (Springer), 2025 -- Microvascular phenotypes in pediatric sepsis identified by machine learning: prognostic implications for organ dysfunction and mortality
2. Frontiers in Medicine, 2026 -- Hematologic and metabolic indices for predicting 28-day mortality in sepsis patients: a retrospective intensive care cohort study
3. Intensive Care Medicine, 2025 -- Subphenotypes of Sepsis, Theragnostic Approaches, and Tailored Management Strategies
4. Frontiers in Immunology, 2026 -- Gut barrier-microbiota crosstalk in sepsis: from pathogenesis to potential therapies
5. Surviving Sepsis Campaign Adult Guidelines | SCCM
6. Core outcome set of daily monitoring of gastrointestinal function in adult critically ill patients: a modified Delphi consensus process (COSMOGI) | Critical Care | Springer Nature Link
7. Frontiers | Prediction models for mortality in patients with sepsis: a systematic review and meta-analysis
8. Surviving Sepsis Campaign Adult Guidelines | SCCM
9. Core outcome set of daily monitoring of gastrointestinal function in adult critically ill patients: a modified Delphi consensus process (COSMOGI) | Critical Care | Springer Nature Link
10. Frontiers | Prediction models for mortality in patients with sepsis: a systematic review and meta-analysis