A Framework for Understanding Systemic Vulnerability and Targeted Care in Sepsis Among Patients with Multimorbidity

Category	Detail
Condition	Sepsis
Key Mechanisms	Dysregulated inflammatory response, low-grade inflammation, impaired immunity, endothelial injury, immunothrombosis, dysbiosis, neuroendocrine maladaptation.
Target Population	Patients with multimorbidity including type 2 diabetes, obesity, heart failure, COPD, chronic kidney disease, cancer/HIV, and severe mental illness.
Care Setting	Hospital settings, particularly intensive care units (ICUs) and neonatal units.

Sepsis is a leading cause of morbidity and mortality, exacerbated by multimorbidity.
Chronic diseases significantly increase the risk and severity of sepsis.
Nosocomial sepsis has high incidence and mortality rates, particularly in critically ill patients.
Personalized care strategies are essential for managing sepsis in patients with comorbidities.
Long-term follow-up is crucial for sepsis survivors due to persistent neurological and psychosocial sequelae.

Identify sepsis through clinical signs of infection and systemic inflammatory response.

Implement mechanism- and phenotype-aligned care, including titrated fluids and timely antimicrobial de-escalation.

Monitor immune and organ function, utilizing markers like monocyte HLA-DR and NGAL/KIM-1.

Patients with multimorbidity, particularly those with chronic conditions.

Focus on rigorous control of chronic comorbidities and preventive strategies against infections.

Clinical Scorecard: A Framework for Understanding Systemic Vulnerability and Targeted Care in Sepsis Among Patients with Multimorbidity