Early Joint Trajectories of Liver-Related Laboratory Biomarkers and 60-Day Mortality in Sepsis-Associated Liver Injury
Qi, Y.-n.; Zhou, T.; Zhao, Q.; Liu, C.
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Background: Sepsis-associated liver injury (SALI) is commonly assessed using static laboratory values, although liver dysfunction during sepsis is dynamic.Methods: This retrospective cohort study included 162 ICU patients with SALI. Early trajectories of alanine aminotransferase, total bilirubin, and albumin during the first 7 days after ICU admission were identified using group-based multi-trajectory modeling. Landmark analysis and Cox regression were used to evaluate 60-day mortality.Results: Twenty-five patients died within 60 days. Four trajectory classes were identified. Between-class separation was driven mainly by alanine aminotransferase and total bilirubin, whereas albumin showed limited short-term variation. After the landmark time point, Class 3 (HR, 4.374; 95% CI, 1.960-9.759; P <0 .001) and Class 4 (HR, 7.451; 95% CI, 3.649-15.212; P <0 .001) had higher mortality risk than Class 1.Conclusions: Early joint trajectories of liver-related laboratory biomarkers may identify clinically meaningful SALI subphenotypes and support risk stratification in critically ill patients.
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