Phenotypic Analysis of Intra-abdominal Sepsis: A Retrospective Observational Study

INTRODUCTION: Intra-abdominal sepsis is a significant healthcare challenge, contributing to high morbidity and mortality among ICU patients. This condition, marked by infection and inflammation within the abdominal cavity, often triggers systemic responses and severe complications. Understanding the phenotypic variations in intra-abdominal sepsis and their influence on patient outcomes is crucial for improving management strategies and prognosis. This retrospective observational study analyzes the sepsis phenotypic variations of patients with intra-abdominal infections, aiming to identify key factors associated with mortality and recovery. METHODS: It was a retrospective observational study was conducted at a tertiary care hospital. The study included patients admitted between January 2021 and December 2023, with data collected from health records on demographic, clinical, and laboratory parameters, as well as treatment interventions. Patients were categorized into four phenotypes based on severity and organ involvement: Phenotype 1 represented sepsis with minimal organ dysfunction, Phenotype 2 showed significant respiratory dysfunction, Phenotype 3 involved multiple organ dysfunctions, and Phenotype 4 was characterized by predominant neurological impairment. Primary outcome was mortality analysis for each Phenotype of sepsis. RESULTS: The study included 290 patients categorized into four phenotypes to assess their ICU mortality rates. Phenotype 3, comprising the largest group (n = 259), demonstrated the highest ICU mortality rate of 42.9%, strongly associated with multiple organ dysfunction and poor outcomes. In contrast, Phenotype 4 (n = 6) exhibited no ICU mortality, suggesting that patients with predominant neurological dysfunction have a better prognosis. Phenotypes 1 (n = 10) and 2 (n = 15) had relatively lower mortality rates of 10% and 20%, respectively, with Phenotype 1 showing the least severe outcomes. These findings, supported by a statistically significant p-value of 0.011, emphasize the importance of phenotype-specific variations in predicting ICU outcomes. Phenotype 3 demands intensive monitoring and aggressive intervention to reduce mortality, while the favorable outcomes in Phenotype 4 highlight the need for nuanced care strategies. Understanding these phenotypic differences is crucial for improving patient outcome in ICU settings. CONCLUSION: Study highlights the significant impact of phenotypic variation on ICU mortality outcomes. Phenotype 3, characterized by multiple organ dysfunctions, emerged as the most critical group with the highest mortality rate, underscoring the need for targeted and intensive interventions for these patients. Conversely, Phenotype 1, 2 and 4 demonstrated a favorable prognosis. These findings underscore the importance of recognizing and addressing phenotypic differences to optimize patient care, improve survival rates, and guide resource allocation in ICU settings.