Dynamic changes in plasma sphingosine-1-phosphate concentrations and mortality in sepsis: a prospective cohort study in the emergency department

Background Sepsis is a dynamic process with evolving host responses, biomarker changes, and organ dysfunction. Sphingosine-1-phosphate (S1P) is a bioactive lipid involved in endothelial and immune regulation. However, the clinical relevance of dynamic S1P changes in sepsis remains unclear. This study aimed to assess their association with mortality. Methods We conducted a prospective cohort study of adults recruited from the emergency department of Wan Fang Hospital between April 2022 and October 2024. Plasma S1P was measured by ELISA on days 1, 3, and before discharge or death. The primary ou

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