Phenotypic heterogeneity by site of infection in surgical sepsis: a prospective longitudinal study

Background The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many survivors now progress into chronic critical illness (CCI). This study sought to determine if there were significant differences in...

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Veröffentlicht in:Critical care (London, England) Jg. 24; H. 1; S. 203 - 14
Hauptverfasser: Stortz, Julie A., Cox, Michael C., Hawkins, Russell B., Ghita, Gabriela L., Brumback, Babette A., Mohr, Alicia M., Moldawer, Lyle L., Efron, Philip A., Brakenridge, Scott C., Moore, Frederick A.
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Sprache:Englisch
Veröffentlicht: London BioMed Central 07.05.2020
BioMed Central Ltd
Springer Nature B.V
BMC
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ISSN:1364-8535, 1466-609X, 1364-8535, 1466-609X, 1366-609X
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Abstract Background The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many survivors now progress into chronic critical illness (CCI). This study sought to determine if there were significant differences in the host response and current epidemiology of surgical sepsis categorized by site of infection. Study design This is a longitudinal study of surgical sepsis patients characterized by baseline predisposition, insult characteristics, serial biomarkers, hospital outcomes, and long-term outcomes. Patients were categorized into five anatomic sites of infection. Results The 316 study patients were predominantly Caucasian; half were male, with a mean age of 62 years, high comorbidity burden, and low 30-day mortality (10%). The primary sites were abdominal (44%), pulmonary (19%), skin/soft tissue (S/ST, 17%), genitourinary (GU, 12%), and vascular (7%). Most abdominal infections were present on admission and required source control. Comparatively, they had more prolonged proinflammation, immunosuppression, and persistent organ dysfunction. Their long-term outcome was poor with 37% CCI (defined as >  14 in ICU with organ dysfunction), 49% poor discharge dispositions, and 30% 1-year mortality. Most pulmonary infections were hospital-acquired pneumonia. They had similar protracted proinflammation and organ dysfunction, but immunosuppression normalized. Long-term outcomes are similarly poor (54% CCI, 47% poor disposition, 32% 1-year mortality). S/ST and GU infections occurred in younger patients with fewer comorbidities, less perturbed immune responses, and faster resolution of organ dysfunction. Comparatively, S/ST had better long-term outcomes (23% CCI, 39% poor disposition, 13% 1-year mortality) and GU had the best (10% CCI, 20% poor disposition, 10% 1-year mortality). Vascular sepsis patients were older males, with more comorbidities. Proinflammation was blunted with baseline immunosuppression and organ dysfunction that persisted. They had the worst long-term outcomes (38% CCI, 67% poor disposition, 57% 1-year mortality). Conclusion There are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study provides unique insights into the host response and long-term outcomes associated with different sites of infection.
AbstractList Background The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many survivors now progress into chronic critical illness (CCI). This study sought to determine if there were significant differences in the host response and current epidemiology of surgical sepsis categorized by site of infection. Study design This is a longitudinal study of surgical sepsis patients characterized by baseline predisposition, insult characteristics, serial biomarkers, hospital outcomes, and long-term outcomes. Patients were categorized into five anatomic sites of infection. Results The 316 study patients were predominantly Caucasian; half were male, with a mean age of 62 years, high comorbidity burden, and low 30-day mortality (10%). The primary sites were abdominal (44%), pulmonary (19%), skin/soft tissue (S/ST, 17%), genitourinary (GU, 12%), and vascular (7%). Most abdominal infections were present on admission and required source control. Comparatively, they had more prolonged proinflammation, immunosuppression, and persistent organ dysfunction. Their long-term outcome was poor with 37% CCI (defined as > 14 in ICU with organ dysfunction), 49% poor discharge dispositions, and 30% 1-year mortality. Most pulmonary infections were hospital-acquired pneumonia. They had similar protracted proinflammation and organ dysfunction, but immunosuppression normalized. Long-term outcomes are similarly poor (54% CCI, 47% poor disposition, 32% 1-year mortality). S/ST and GU infections occurred in younger patients with fewer comorbidities, less perturbed immune responses, and faster resolution of organ dysfunction. Comparatively, S/ST had better long-term outcomes (23% CCI, 39% poor disposition, 13% 1-year mortality) and GU had the best (10% CCI, 20% poor disposition, 10% 1-year mortality). Vascular sepsis patients were older males, with more comorbidities. Proinflammation was blunted with baseline immunosuppression and organ dysfunction that persisted. They had the worst long-term outcomes (38% CCI, 67% poor disposition, 57% 1-year mortality). Conclusion There are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study provides unique insights into the host response and long-term outcomes associated with different sites of infection.
The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many survivors now progress into chronic critical illness (CCI). This study sought to determine if there were significant differences in the host response and current epidemiology of surgical sepsis categorized by site of infection.BACKGROUNDThe role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many survivors now progress into chronic critical illness (CCI). This study sought to determine if there were significant differences in the host response and current epidemiology of surgical sepsis categorized by site of infection.This is a longitudinal study of surgical sepsis patients characterized by baseline predisposition, insult characteristics, serial biomarkers, hospital outcomes, and long-term outcomes. Patients were categorized into five anatomic sites of infection.STUDY DESIGNThis is a longitudinal study of surgical sepsis patients characterized by baseline predisposition, insult characteristics, serial biomarkers, hospital outcomes, and long-term outcomes. Patients were categorized into five anatomic sites of infection.The 316 study patients were predominantly Caucasian; half were male, with a mean age of 62 years, high comorbidity burden, and low 30-day mortality (10%). The primary sites were abdominal (44%), pulmonary (19%), skin/soft tissue (S/ST, 17%), genitourinary (GU, 12%), and vascular (7%). Most abdominal infections were present on admission and required source control. Comparatively, they had more prolonged proinflammation, immunosuppression, and persistent organ dysfunction. Their long-term outcome was poor with 37% CCI (defined as > 14 in ICU with organ dysfunction), 49% poor discharge dispositions, and 30% 1-year mortality. Most pulmonary infections were hospital-acquired pneumonia. They had similar protracted proinflammation and organ dysfunction, but immunosuppression normalized. Long-term outcomes are similarly poor (54% CCI, 47% poor disposition, 32% 1-year mortality). S/ST and GU infections occurred in younger patients with fewer comorbidities, less perturbed immune responses, and faster resolution of organ dysfunction. Comparatively, S/ST had better long-term outcomes (23% CCI, 39% poor disposition, 13% 1-year mortality) and GU had the best (10% CCI, 20% poor disposition, 10% 1-year mortality). Vascular sepsis patients were older males, with more comorbidities. Proinflammation was blunted with baseline immunosuppression and organ dysfunction that persisted. They had the worst long-term outcomes (38% CCI, 67% poor disposition, 57% 1-year mortality).RESULTSThe 316 study patients were predominantly Caucasian; half were male, with a mean age of 62 years, high comorbidity burden, and low 30-day mortality (10%). The primary sites were abdominal (44%), pulmonary (19%), skin/soft tissue (S/ST, 17%), genitourinary (GU, 12%), and vascular (7%). Most abdominal infections were present on admission and required source control. Comparatively, they had more prolonged proinflammation, immunosuppression, and persistent organ dysfunction. Their long-term outcome was poor with 37% CCI (defined as > 14 in ICU with organ dysfunction), 49% poor discharge dispositions, and 30% 1-year mortality. Most pulmonary infections were hospital-acquired pneumonia. They had similar protracted proinflammation and organ dysfunction, but immunosuppression normalized. Long-term outcomes are similarly poor (54% CCI, 47% poor disposition, 32% 1-year mortality). S/ST and GU infections occurred in younger patients with fewer comorbidities, less perturbed immune responses, and faster resolution of organ dysfunction. Comparatively, S/ST had better long-term outcomes (23% CCI, 39% poor disposition, 13% 1-year mortality) and GU had the best (10% CCI, 20% poor disposition, 10% 1-year mortality). Vascular sepsis patients were older males, with more comorbidities. Proinflammation was blunted with baseline immunosuppression and organ dysfunction that persisted. They had the worst long-term outcomes (38% CCI, 67% poor disposition, 57% 1-year mortality).There are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study provides unique insights into the host response and long-term outcomes associated with different sites of infection.CONCLUSIONThere are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study provides unique insights into the host response and long-term outcomes associated with different sites of infection.
Background The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many survivors now progress into chronic critical illness (CCI). This study sought to determine if there were significant differences in the host response and current epidemiology of surgical sepsis categorized by site of infection. Study design This is a longitudinal study of surgical sepsis patients characterized by baseline predisposition, insult characteristics, serial biomarkers, hospital outcomes, and long-term outcomes. Patients were categorized into five anatomic sites of infection. Results The 316 study patients were predominantly Caucasian; half were male, with a mean age of 62 years, high comorbidity burden, and low 30-day mortality (10%). The primary sites were abdominal (44%), pulmonary (19%), skin/soft tissue (S/ST, 17%), genitourinary (GU, 12%), and vascular (7%). Most abdominal infections were present on admission and required source control. Comparatively, they had more prolonged proinflammation, immunosuppression, and persistent organ dysfunction. Their long-term outcome was poor with 37% CCI (defined as >  14 in ICU with organ dysfunction), 49% poor discharge dispositions, and 30% 1-year mortality. Most pulmonary infections were hospital-acquired pneumonia. They had similar protracted proinflammation and organ dysfunction, but immunosuppression normalized. Long-term outcomes are similarly poor (54% CCI, 47% poor disposition, 32% 1-year mortality). S/ST and GU infections occurred in younger patients with fewer comorbidities, less perturbed immune responses, and faster resolution of organ dysfunction. Comparatively, S/ST had better long-term outcomes (23% CCI, 39% poor disposition, 13% 1-year mortality) and GU had the best (10% CCI, 20% poor disposition, 10% 1-year mortality). Vascular sepsis patients were older males, with more comorbidities. Proinflammation was blunted with baseline immunosuppression and organ dysfunction that persisted. They had the worst long-term outcomes (38% CCI, 67% poor disposition, 57% 1-year mortality). Conclusion There are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study provides unique insights into the host response and long-term outcomes associated with different sites of infection.
The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many survivors now progress into chronic critical illness (CCI). This study sought to determine if there were significant differences in the host response and current epidemiology of surgical sepsis categorized by site of infection. This is a longitudinal study of surgical sepsis patients characterized by baseline predisposition, insult characteristics, serial biomarkers, hospital outcomes, and long-term outcomes. Patients were categorized into five anatomic sites of infection. The 316 study patients were predominantly Caucasian; half were male, with a mean age of 62 years, high comorbidity burden, and low 30-day mortality (10%). The primary sites were abdominal (44%), pulmonary (19%), skin/soft tissue (S/ST, 17%), genitourinary (GU, 12%), and vascular (7%). Most abdominal infections were present on admission and required source control. Comparatively, they had more prolonged proinflammation, immunosuppression, and persistent organ dysfunction. Their long-term outcome was poor with 37% CCI (defined as 14 in ICU with organ dysfunction), 49% poor discharge dispositions, and 30% 1-year mortality. Most pulmonary infections were hospital-acquired pneumonia. They had similar protracted proinflammation and organ dysfunction, but immunosuppression normalized. Long-term outcomes are similarly poor (54% CCI, 47% poor disposition, 32% 1-year mortality). S/ST and GU infections occurred in younger patients with fewer comorbidities, less perturbed immune responses, and faster resolution of organ dysfunction. Comparatively, S/ST had better long-term outcomes (23% CCI, 39% poor disposition, 13% 1-year mortality) and GU had the best (10% CCI, 20% poor disposition, 10% 1-year mortality). Vascular sepsis patients were older males, with more comorbidities. Proinflammation was blunted with baseline immunosuppression and organ dysfunction that persisted. They had the worst long-term outcomes (38% CCI, 67% poor disposition, 57% 1-year mortality). There are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study provides unique insights into the host response and long-term outcomes associated with different sites of infection.
The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many survivors now progress into chronic critical illness (CCI). This study sought to determine if there were significant differences in the host response and current epidemiology of surgical sepsis categorized by site of infection. This is a longitudinal study of surgical sepsis patients characterized by baseline predisposition, insult characteristics, serial biomarkers, hospital outcomes, and long-term outcomes. Patients were categorized into five anatomic sites of infection. The 316 study patients were predominantly Caucasian; half were male, with a mean age of 62 years, high comorbidity burden, and low 30-day mortality (10%). The primary sites were abdominal (44%), pulmonary (19%), skin/soft tissue (S/ST, 17%), genitourinary (GU, 12%), and vascular (7%). Most abdominal infections were present on admission and required source control. Comparatively, they had more prolonged proinflammation, immunosuppression, and persistent organ dysfunction. Their long-term outcome was poor with 37% CCI (defined as > 14 in ICU with organ dysfunction), 49% poor discharge dispositions, and 30% 1-year mortality. Most pulmonary infections were hospital-acquired pneumonia. They had similar protracted proinflammation and organ dysfunction, but immunosuppression normalized. Long-term outcomes are similarly poor (54% CCI, 47% poor disposition, 32% 1-year mortality). S/ST and GU infections occurred in younger patients with fewer comorbidities, less perturbed immune responses, and faster resolution of organ dysfunction. Comparatively, S/ST had better long-term outcomes (23% CCI, 39% poor disposition, 13% 1-year mortality) and GU had the best (10% CCI, 20% poor disposition, 10% 1-year mortality). Vascular sepsis patients were older males, with more comorbidities. Proinflammation was blunted with baseline immunosuppression and organ dysfunction that persisted. They had the worst long-term outcomes (38% CCI, 67% poor disposition, 57% 1-year mortality). There are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study provides unique insights into the host response and long-term outcomes associated with different sites of infection.
Abstract Background The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many survivors now progress into chronic critical illness (CCI). This study sought to determine if there were significant differences in the host response and current epidemiology of surgical sepsis categorized by site of infection. Study design This is a longitudinal study of surgical sepsis patients characterized by baseline predisposition, insult characteristics, serial biomarkers, hospital outcomes, and long-term outcomes. Patients were categorized into five anatomic sites of infection. Results The 316 study patients were predominantly Caucasian; half were male, with a mean age of 62 years, high comorbidity burden, and low 30-day mortality (10%). The primary sites were abdominal (44%), pulmonary (19%), skin/soft tissue (S/ST, 17%), genitourinary (GU, 12%), and vascular (7%). Most abdominal infections were present on admission and required source control. Comparatively, they had more prolonged proinflammation, immunosuppression, and persistent organ dysfunction. Their long-term outcome was poor with 37% CCI (defined as > 14 in ICU with organ dysfunction), 49% poor discharge dispositions, and 30% 1-year mortality. Most pulmonary infections were hospital-acquired pneumonia. They had similar protracted proinflammation and organ dysfunction, but immunosuppression normalized. Long-term outcomes are similarly poor (54% CCI, 47% poor disposition, 32% 1-year mortality). S/ST and GU infections occurred in younger patients with fewer comorbidities, less perturbed immune responses, and faster resolution of organ dysfunction. Comparatively, S/ST had better long-term outcomes (23% CCI, 39% poor disposition, 13% 1-year mortality) and GU had the best (10% CCI, 20% poor disposition, 10% 1-year mortality). Vascular sepsis patients were older males, with more comorbidities. Proinflammation was blunted with baseline immunosuppression and organ dysfunction that persisted. They had the worst long-term outcomes (38% CCI, 67% poor disposition, 57% 1-year mortality). Conclusion There are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study provides unique insights into the host response and long-term outcomes associated with different sites of infection.
Background The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many survivors now progress into chronic critical illness (CCI). This study sought to determine if there were significant differences in the host response and current epidemiology of surgical sepsis categorized by site of infection. Study design This is a longitudinal study of surgical sepsis patients characterized by baseline predisposition, insult characteristics, serial biomarkers, hospital outcomes, and long-term outcomes. Patients were categorized into five anatomic sites of infection. Results The 316 study patients were predominantly Caucasian; half were male, with a mean age of 62 years, high comorbidity burden, and low 30-day mortality (10%). The primary sites were abdominal (44%), pulmonary (19%), skin/soft tissue (S/ST, 17%), genitourinary (GU, 12%), and vascular (7%). Most abdominal infections were present on admission and required source control. Comparatively, they had more prolonged proinflammation, immunosuppression, and persistent organ dysfunction. Their long-term outcome was poor with 37% CCI (defined as 14 in ICU with organ dysfunction), 49% poor discharge dispositions, and 30% 1-year mortality. Most pulmonary infections were hospital-acquired pneumonia. They had similar protracted proinflammation and organ dysfunction, but immunosuppression normalized. Long-term outcomes are similarly poor (54% CCI, 47% poor disposition, 32% 1-year mortality). S/ST and GU infections occurred in younger patients with fewer comorbidities, less perturbed immune responses, and faster resolution of organ dysfunction. Comparatively, S/ST had better long-term outcomes (23% CCI, 39% poor disposition, 13% 1-year mortality) and GU had the best (10% CCI, 20% poor disposition, 10% 1-year mortality). Vascular sepsis patients were older males, with more comorbidities. Proinflammation was blunted with baseline immunosuppression and organ dysfunction that persisted. They had the worst long-term outcomes (38% CCI, 67% poor disposition, 57% 1-year mortality). Conclusion There are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study provides unique insights into the host response and long-term outcomes associated with different sites of infection. Keywords: Surgical sepsis, Site of infection, Phenotypes, Chronic critical illness, Heterogeneity, Long-term outcomes, Functional outcomes, Proinflammation, Immunosuppression, Organ dysfunction
ArticleNumber 203
Audience Academic
Author Moore, Frederick A.
Efron, Philip A.
Moldawer, Lyle L.
Ghita, Gabriela L.
Cox, Michael C.
Mohr, Alicia M.
Stortz, Julie A.
Hawkins, Russell B.
Brakenridge, Scott C.
Brumback, Babette A.
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  organization: Department of Surgery, University of Florida College of Medicine
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  givenname: Michael C.
  surname: Cox
  fullname: Cox, Michael C.
  organization: Department of Surgery, University of Florida College of Medicine
– sequence: 3
  givenname: Russell B.
  surname: Hawkins
  fullname: Hawkins, Russell B.
  organization: Department of Surgery, University of Florida College of Medicine
– sequence: 4
  givenname: Gabriela L.
  surname: Ghita
  fullname: Ghita, Gabriela L.
  organization: Department of Biostatistics, University of Florida
– sequence: 5
  givenname: Babette A.
  surname: Brumback
  fullname: Brumback, Babette A.
  organization: Department of Biostatistics, University of Florida
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  givenname: Alicia M.
  surname: Mohr
  fullname: Mohr, Alicia M.
  organization: Department of Surgery, University of Florida College of Medicine
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  givenname: Lyle L.
  surname: Moldawer
  fullname: Moldawer, Lyle L.
  organization: Department of Surgery, University of Florida College of Medicine
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  givenname: Philip A.
  surname: Efron
  fullname: Efron, Philip A.
  organization: Department of Surgery, University of Florida College of Medicine
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  givenname: Scott C.
  surname: Brakenridge
  fullname: Brakenridge, Scott C.
  organization: Department of Surgery, University of Florida College of Medicine
– sequence: 10
  givenname: Frederick A.
  surname: Moore
  fullname: Moore, Frederick A.
  email: frederick.moore@surgery.ufl.edu
  organization: Department of Surgery, University of Florida College of Medicine
BackLink https://www.ncbi.nlm.nih.gov/pubmed/32381107$$D View this record in MEDLINE/PubMed
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Cites_doi 10.1097/TA.0b013e318256e000
10.1097/TA.0b013e31820e7803
10.1016/j.molmed.2014.01.007
10.1177/0885066615627778
10.1097/SHK.0000000000000981
10.1001/archsurg.1990.01410130019002
10.1097/CCM.0b013e31821b827c
10.1097/TA.0000000000001758
10.1001/jama.2016.0287
10.1097/SLA.0000000000003458
10.1001/jamanetworkopen.2018.7571
10.1016/j.jcrc.2009.09.005
10.1001/jama.2019.5791
10.1097/CCM.0000000000001658
10.1378/chest.101.6.1644
10.1097/00000421-198212000-00014
10.1164/rccm.201812-2383CP
10.1164/rccm.201310-1875OC
10.1097/TA.0b013e31821598e9
10.3389/fimmu.2018.01511
10.1007/s00134-003-1662-x
10.1001/jamanetworkopen.2019.8686
10.1097/TA.0000000000000121
10.1001/jama.2018.9071
10.1136/bmj.i2375
10.1186/s40560-019-0383-3
10.1097/CCM.0000000000002011
10.1001/jama.2017.13836
10.1097/00005373-199604000-00001
10.4161/viru.26908
10.1016/j.jcrc.2017.05.019
10.1097/CCM.0000000000000297
10.1136/bmjopen-2016-015136
10.1001/jama.2014.5804
10.1097/CCM.0000000000003655
10.1186/cc8909
10.1111/njs.16435
10.1097/MD.0000000000015276
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Issue 1
Keywords Heterogeneity
Phenotypes
Immunosuppression
Chronic critical illness
Proinflammation
Functional outcomes
Long-term outcomes
Site of infection
Organ dysfunction
Surgical sepsis
Language English
License Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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References JC Marshall (2917_CR7) 2014; 20
N Jeganathan (2917_CR14) 2017; 41
LJ Moore (2917_CR29) 2011; 70
J Marshall (2917_CR4) 1990; 125
IVR Evans (2917_CR17) 2018; 320
JA Stortz (2917_CR27) 2018; 49
CW Seymour (2917_CR10) 2019; 321
JC Marshall (2917_CR31) 2014; 5
HC Prescott (2917_CR36) 2019; 200
MM Levy (2917_CR37) 2003; 29
SC Brakenridge (2917_CR39) 2018; 49
A Leligdowicz (2917_CR12) 2014; 189
C Rhee (2917_CR2) 2017; 318
2917_CR8
T Abe (2917_CR15) 2019; 7
MCV Guilamet (2917_CR9) 2019; 98
E Volakli (2917_CR33) 2010; 14
V Liu (2917_CR1) 2014; 312
MM Oken (2917_CR30) 1982; 5
RB Hawkins (2917_CR25) 2018; 9
2917_CR34
S Lobo (2917_CR11) 2010; 25
CA Croft (2917_CR16) 2014; 76
HC Prescott (2917_CR20) 2016; 353
SC Brakenridge (2917_CR22) 2019; 270
AK Gardner (2917_CR21) 2019; 47
M Singer (2917_CR38) 2016; 315
BA McKinley (2917_CR23) 2011; 70
S Yende (2917_CR40) 2019; 2
C Rhee (2917_CR3) 2019; 2
S Yende (2917_CR19) 2016; 44
JA Stortz (2917_CR26) 2018; 84
RC Bone (2917_CR5) 1992; 101
TJ Loftus (2917_CR28) 2017; 7
FA Moore (2917_CR32) 1996; 40
AR van Zanten (2917_CR18) 2014; 42
ML Martinez (2917_CR35) 2017; 45
CA Motzkus (2917_CR13) 2017; 32
JR Zahar (2917_CR6) 2011; 39
LF Gentile (2917_CR24) 2012; 72
References_xml – volume: 72
  start-page: 1491
  year: 2012
  ident: 2917_CR24
  publication-title: J Trauma Acute Care Surg
  doi: 10.1097/TA.0b013e318256e000
– volume: 70
  start-page: 672
  issue: 3
  year: 2011
  ident: 2917_CR29
  publication-title: J Trauma
  doi: 10.1097/TA.0b013e31820e7803
– volume: 20
  start-page: 195
  year: 2014
  ident: 2917_CR7
  publication-title: Trends Mol Med
  doi: 10.1016/j.molmed.2014.01.007
– volume: 32
  start-page: 473
  year: 2017
  ident: 2917_CR13
  publication-title: J Intensive Care Med
  doi: 10.1177/0885066615627778
– volume: 49
  start-page: 249
  issue: 3
  year: 2018
  ident: 2917_CR27
  publication-title: Shock.
  doi: 10.1097/SHK.0000000000000981
– volume: 125
  start-page: 17
  year: 1990
  ident: 2917_CR4
  publication-title: Arch Surg
  doi: 10.1001/archsurg.1990.01410130019002
– volume: 39
  start-page: 1886
  year: 2011
  ident: 2917_CR6
  publication-title: Crit Care Med
  doi: 10.1097/CCM.0b013e31821b827c
– volume: 84
  start-page: 342
  issue: 2
  year: 2018
  ident: 2917_CR26
  publication-title: J Trauma Acute Care Surg
  doi: 10.1097/TA.0000000000001758
– volume: 315
  start-page: 801
  year: 2016
  ident: 2917_CR38
  publication-title: JAMA
  doi: 10.1001/jama.2016.0287
– volume: 270
  start-page: 502
  year: 2019
  ident: 2917_CR22
  publication-title: Ann Surg
  doi: 10.1097/SLA.0000000000003458
– volume: 2
  start-page: e187571
  issue: 2
  year: 2019
  ident: 2917_CR3
  publication-title: JAMA Netw Open
  doi: 10.1001/jamanetworkopen.2018.7571
– volume: 25
  start-page: 391
  year: 2010
  ident: 2917_CR11
  publication-title: J Crit Care
  doi: 10.1016/j.jcrc.2009.09.005
– ident: 2917_CR8
– volume: 321
  start-page: 2003
  year: 2019
  ident: 2917_CR10
  publication-title: JAMA.
  doi: 10.1001/jama.2019.5791
– volume: 44
  start-page: 1461
  year: 2016
  ident: 2917_CR19
  publication-title: Crit Care Med
  doi: 10.1097/CCM.0000000000001658
– volume: 101
  start-page: 1644
  year: 1992
  ident: 2917_CR5
  publication-title: Chest.
  doi: 10.1378/chest.101.6.1644
– volume: 5
  start-page: 649
  year: 1982
  ident: 2917_CR30
  publication-title: Am J Clin Oncol
  doi: 10.1097/00000421-198212000-00014
– volume: 200
  start-page: 972
  year: 2019
  ident: 2917_CR36
  publication-title: Am J Respir Crit Care Med
  doi: 10.1164/rccm.201812-2383CP
– volume: 189
  start-page: 1204
  year: 2014
  ident: 2917_CR12
  publication-title: Am J Respir Crit Care Med
  doi: 10.1164/rccm.201310-1875OC
– volume: 70
  start-page: 1153
  year: 2011
  ident: 2917_CR23
  publication-title: J Trauma
  doi: 10.1097/TA.0b013e31821598e9
– volume: 9
  start-page: 1511
  year: 2018
  ident: 2917_CR25
  publication-title: Front Immunol
  doi: 10.3389/fimmu.2018.01511
– volume: 29
  start-page: 530
  year: 2003
  ident: 2917_CR37
  publication-title: Intensive Care Med
  doi: 10.1007/s00134-003-1662-x
– volume: 2
  start-page: e198686
  issue: 8
  year: 2019
  ident: 2917_CR40
  publication-title: JAMA New Open
  doi: 10.1001/jamanetworkopen.2019.8686
– volume: 76
  start-page: 311
  year: 2014
  ident: 2917_CR16
  publication-title: J Trauma Acute Care Surg
  doi: 10.1097/TA.0000000000000121
– volume: 320
  start-page: 358
  year: 2018
  ident: 2917_CR17
  publication-title: JAMA.
  doi: 10.1001/jama.2018.9071
– volume: 353
  start-page: i2375
  year: 2016
  ident: 2917_CR20
  publication-title: BMJ.
  doi: 10.1136/bmj.i2375
– volume: 7
  start-page: 28
  year: 2019
  ident: 2917_CR15
  publication-title: J Intensive Care
  doi: 10.1186/s40560-019-0383-3
– volume: 45
  start-page: 11
  year: 2017
  ident: 2917_CR35
  publication-title: Crit Care Med
  doi: 10.1097/CCM.0000000000002011
– volume: 318
  start-page: 1241
  year: 2017
  ident: 2917_CR2
  publication-title: JAMA.
  doi: 10.1001/jama.2017.13836
– volume: 40
  start-page: 501
  year: 1996
  ident: 2917_CR32
  publication-title: J Trauma
  doi: 10.1097/00005373-199604000-00001
– volume: 5
  start-page: 27
  year: 2014
  ident: 2917_CR31
  publication-title: Virulence
  doi: 10.4161/viru.26908
– volume: 41
  start-page: 170
  year: 2017
  ident: 2917_CR14
  publication-title: J Crit Care
  doi: 10.1016/j.jcrc.2017.05.019
– volume: 42
  start-page: 1890
  year: 2014
  ident: 2917_CR18
  publication-title: Crit Care Med
  doi: 10.1097/CCM.0000000000000297
– volume: 7
  start-page: e015136
  issue: 7
  year: 2017
  ident: 2917_CR28
  publication-title: BMJ Open
  doi: 10.1136/bmjopen-2016-015136
– volume: 49
  start-page: 138
  issue: Suppl 6
  year: 2018
  ident: 2917_CR39
  publication-title: Shock
– volume: 312
  start-page: 90
  year: 2014
  ident: 2917_CR1
  publication-title: JAMA.
  doi: 10.1001/jama.2014.5804
– volume: 47
  start-page: 566
  year: 2019
  ident: 2917_CR21
  publication-title: Crit Care Med
  doi: 10.1097/CCM.0000000000003655
– volume: 14
  start-page: R32
  issue: 2
  year: 2010
  ident: 2917_CR33
  publication-title: Crit Care
  doi: 10.1186/cc8909
– ident: 2917_CR34
  doi: 10.1111/njs.16435
– volume: 98
  issue: 16
  year: 2019
  ident: 2917_CR9
  publication-title: Medicine (Baltimore)
  doi: 10.1097/MD.0000000000015276
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Snippet Background The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased,...
The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased, but many...
Background The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has decreased,...
Abstract Background The role of site of infection in sepsis has been poorly characterized. Additionally, sepsis epidemiology has evolved. Early mortality has...
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SubjectTerms Abdomen
Activities of daily living
Aged
Chronic critical illness
Clinical trials
Cohort Studies
Comorbidity
Critical care
Critical Care Medicine
Critical Illness - epidemiology
Cross infection
Disability
Emergency Medicine
Epidemiology
Female
Health aspects
Heterogeneity
Hospital Mortality - trends
Hospital patients
Hospitals
Humans
Hypotheses
Illnesses
Immunotherapy
Infections
Intensive
Intensive care
Long-term outcomes
Longitudinal Studies
Male
Medical records
Medical research
Medicine
Medicine & Public Health
Middle Aged
Mortality
Patients
Phenotype
Phenotypes
Pneumonia
Postoperative Complications - etiology
Prospective Studies
Risk Factors
Sepsis
Sepsis - classification
Sepsis - etiology
Site of infection
Surgery
Surgical sepsis
Surgical Wound Infection - classification
Surgical Wound Infection - complications
Trauma
Ventilators
Viral infections
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Title Phenotypic heterogeneity by site of infection in surgical sepsis: a prospective longitudinal study
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