Development and Validation of Temperature Trajectory-Based Phenotypes in Pediatric Sepsis: A Multicenter Retrospective Cohort Study, 2012–2018

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In critically ill children with sepsis, temperature trajectories can be classified into hyperthermic, normothermic, and hypothermic phenotypes, with the hypothermic phenotype being independently associated with significantly higher odds of persistent multiple organ dysfunction syndrome and ICU mortality. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Stephanie R. Brown; L. Nelson Sanchez-Pinto; Jocelyn R. Grunwell; Xiao Hu; Craig M. Coopersmith; Mihir R. Atreya; Colin Rogerson; Alon Geva; Tellen D. Bennett; Grace Chong; Sareen Shah; Mark W. Hall; Sivasubramanium V. Bhavani

doi:10.1097/pcc.0000000000004031

August 24, 2026Pediatric Critical Care Medicine

Development and Validation of Temperature Trajectory-Based Phenotypes in Pediatric Sepsis: A Multicenter Retrospective Cohort Study, 2012–2018

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Key Points

To derive and validate longitudinal temperature trajectory-based phenotypes in critically ill children with sepsis and assess their independent associations with clinical outcomes.
Retrospective observational cohort study of 11,566 children (0–18 years) with community-acquired sepsis meeting Phoenix criteria across 13 PICUs in the United States (2012–2018).
Eligible patients survived at least 24 hours and had 4 or more temperature measurements recorded during the first 24 hours of PICU admission.
Group-based trajectory modeling was applied to identify temperature phenotypes, evaluating persistent multiple organ dysfunction syndrome (MODS) at day 7 and PICU mortality.
Three distinct phenotypes were identified: hyperthermic (35%), normothermic (59%), and hypothermic (6%).
The hypothermic phenotype demonstrated the highest risk of adverse outcomes, with elevated odds of day 7 persistent MODS (OR 5, 95% CI 4–6) and PICU mortality (OR 11, 95% CI 9–15).
Associations between the hypothermic trajectory and poor clinical outcomes remained significant after adjusting for admission hypothermia (< 35°C), baseline illness severity, age, and technology dependence.

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Implication

Retrospective cohort study reveals that hypothermic temperature trajectories are associated with higher organ dysfunction and mortality in pediatric sepsis, suggesting distinct clinical risk profiles.

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Brown et al. (2026) studied this question.

synapsesocial.com/papers/6a8e9b68451774b83f3b431b https://doi.org/10.1097/pcc.0000000000004031

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Development and Validation of Temperature Trajectory-Based Phenotypes in Pediatric Sepsis: A Multicenter Retrospective Cohort Study, 2012–2018

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Development and Validation of Temperature Trajectory-Based Phenotypes in Pediatric Sepsis: A Multicenter Retrospective Cohort Study, 2012–2018

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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