Heterogeneity in sepsis: Subtypes of sepsis - Systematic review

ABSTRACT

Introduction: It is widely known that the high heterogeneity in sepsis is an obstacle to the research efforts, causing great confusion in the medical community concerning the results interpretation. This is why it is of outstanding significance to categorize sepsis into subtypes (of patients) which share the same characteristics.

The purpose of this article was to provide a systematic review of subcategories of patients with sepsis, which are highlighted in the literature as subtypes, subcategories, subgroups and endotypes in order to see if this categorization improves the final outcome in sepsis.

Methods: A research at the MEDLINE (Pubmed) database was made using all the possible combinations of the word sepsis with the words subtypes, subphenotypes, phenotypes, subclasses, subgroups, clusters and endotypes.

Results: The research yielded 13 articles, 9 out of which were about subtypes of sepsis based on clinical and laboratory variables and 4 referred to sepsis subtypes through genomic and transcriptomic analysis.

Conclusions: Sepsis is characterized by great diversity, so the research is oriented to sub-classify the disease in subtypes. The aim of the subclassification is to have a greater understanding of the pathophysiology of the disease and recommend more targeted therapies.

Keywords: sepsis, heterogeneity, subtypes, endotypes