Association between serum osmolality trajectories and mortality in sepsis patients: a retrospective multi-cohort study

Dynamic serum osmolality trajectories are independent predictors of mortality in sepsis, with effects partially mediated through renal dysfunction and fluid imbalance. These findings support the implementation of trajectory-guided precision fluid therapy as a novel framework for individualized sepsis care, challenging one-size-fits-all approaches and offering evidence-based guidance for personalized treatment strategies.