{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T12:40:44Z","timestamp":1773751244111,"version":"3.50.1"},"reference-count":15,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: To determine and validate the cluster trajectory model by dynamic subphenotypes of vital signs in infecti ons and prediction of 30-day mortality. Methods: We conducted a prospective study in the emergency department of Cl\u00ednica Colombia with patients with suspected infection. Clinical data, vital signs, and 30-day mortality were collected. Vital signs were measured within the first 24 h of admission, and patients were classified according to a vital signs trajectory model into four groups: A, B, C, and D. Results: The final cohort consisted of 625 patients, and the subphenotypes, according to the vital signs, were as follows: A\u20142.66% (all vital signs altered), B\u20149.2% (at least one alteration, predominantly hypertension), C\u201419% (minimal or no alteration, control), D\u201469.2% (only arterial hypotension). The primary outcome was mortality. Overall mortality was 8.6%, being higher in group A followed by D, B and C (p = 0.009). The risk increased progressively in groups B (OR = 2.87, CI 95%: 0.62\u201313.25), D (OR = 4.77, CI 95%: 1.46\u201315.58), and A (OR = 8.33, CI 95%: 1.54\u201345.05). Group A presented more frequently with pneumonia (p = 0.002), CNS infections (p = 0.021), mechanical ventilation (p &lt; 0.001), and vasopressor support (p &lt; 0.001). Significant differences among groups were found in leukocytosis (B vs. C p = 0.026), neutrophilia (B vs. C p = 0.001 and B vs. D p = 0.042), lymphocytosis (B vs. D p = 0.002), neutrophil\/lymphocyte ratio (A vs. C p = 0. 010), lactate (C vs. D p = 0.044), anemia (B vs. D p = 0.013 and C vs. D p = 0.001), and CRP (A vs. C p = 0.004, B vs. C p &lt; 0.001 and C vs. D p &lt; 0.001). Conclusions: Patients with suspected infection and more altered vital signs have higher mortality (group A) and benefit from earlier interventions by sepsis teams in the emergency department.<\/jats:p>","DOI":"10.3390\/jcm15062264","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T09:35:57Z","timestamp":1773740157000},"page":"2264","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive Model of Dynamic Subphenotypes for 30-Day Mortality in Emergency Department Patients with Suspected Infection Using the Vital Signs of the First 24 Hours: An Analytical Cohort Study in a Tertiary Care Clinic"],"prefix":"10.3390","volume":"15","author":[{"given":"Alvaro","family":"Pati\u00f1o-Moncayo","sequence":"first","affiliation":[{"name":"Especializaci\u00f3n en Medicina Interna, Facultad de Medicina, Fundaci\u00f3n Universitaria Sanitas, Bogot\u00e1 110111, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milc\u00edades","family":"Iba\u00f1ez-Pinilla","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Traslacional, Unidad de Investigaci\u00f3n, Facultad de Medicina, Fundaci\u00f3n Universitaria Sanitas, Bogot\u00e1 110111, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7526-8683","authenticated-orcid":false,"given":"Manuel","family":"Gonzalez-Varela","sequence":"additional","affiliation":[{"name":"Especializaci\u00f3n en Medicina Interna, Facultad de Medicina, Fundaci\u00f3n Universitaria Sanitas, Bogot\u00e1 110111, Colombia"},{"name":"Grupo de Investigaci\u00f3n de Medicina Cr\u00edtica y Cuidado Intensivo, Department of Emergency Medicine, Cl\u00ednica Colsanitas S.A., Cl\u00ednica Universitaria Colombia, Bogot\u00e1 110111, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Carlos","family":"Martinez","sequence":"additional","affiliation":[{"name":"Especializaci\u00f3n en Medicina Interna, Facultad de Medicina, Fundaci\u00f3n Universitaria Sanitas, Bogot\u00e1 110111, Colombia"},{"name":"Grupo de Investigaci\u00f3n de Medicina Cr\u00edtica y Cuidado Intensivo, Department of Internal Medicine, Cl\u00ednica Colsanitas S.A., Cl\u00ednica Universitaria Colombia, Bogot\u00e1 110111, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luisa Fernanda","family":"Pati\u00f1o-Unibio","sequence":"additional","affiliation":[{"name":"Especializaci\u00f3n en Medicina Interna, Facultad de Medicina, Fundaci\u00f3n Universitaria Sanitas, Bogot\u00e1 110111, Colombia"},{"name":"Grupo de Investigaci\u00f3n INPAC, Department of Internal Medicine, Cl\u00ednica Colsanitas S.A., Cl\u00ednica Universitaria Colombia, Bogot\u00e1 110111, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1007\/s00134-022-06890-z","article-title":"Development and validation of novel sepsis subphenotypes using trajectories of vital signs","volume":"48","author":"Bhavani","year":"2022","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1063","DOI":"10.1097\/CCM.0000000000005337","article-title":"Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021","volume":"49","author":"Evans","year":"2021","journal-title":"Crit. 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