Preceding organ trajectories guide dynamic reassessment after apparent stabilisation in sepsis

In 19,690 adults with sepsis across four ICU databases, using preceding organ trajectories increased 6-hour deterioration reassessment capture from 219 to 282 episodes (28.8%).

• Why it matters: Apparent organ recovery after apparent stabilization can hide ongoing vulnerability, risking missed deterioration and less accurate treatment prioritization.
• What they did: They evaluated six-hour worsening in low-severity organs after transition to single-organ dysfunction, and at 2,492 eICU reassessment alerts tested whether adding updated trajectory history improved episode capture and nomination timing.
• The result: Trajectory-informed reassessment improved hypotension-or-death discrimination in 813 norepinephrine-treated patients (AUROC 0.5925 to 0.6929) and, with local calibration and alert scheduling, supported better dynamic reassessment and treatment prioritisation.

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