Chung KP, et al. - In prospective multicenter cohort studies with derivation and validation cohort design, researchers ascertained the role of plasma carnitine and acylcarnitines in reflecting the severity of sepsis as well as sought corroboration for the role of specific acylcarnitines in prognostic assessment. Participants were patients with sepsis and acute organ dysfunction, 90 in the derivation and 120 in validation cohorts. They found that increased plasma levels of short- and medium-chain acylcarnitines were remarkably related to hepatobiliary dysfunction, renal dysfunction, thrombocytopenia, and hyperlactatemia in the derivation cohort. They also noted a significantly increased 28-day mortality among patients with high plasma acetylcarnitine (≥ 6,000 ng/mL) vs those with plasma acetylcarnitine less than 6,000 ng/mL (52.6% vs 13.9%). Overall, plasma acetylcarnitine was confirmed to be reflective of the severity of organ dysfunction, inflammation, and infection in sepsis and could serve as a prognostic biomarker for mortality prediction.