Supplemental Table 1: Characteristics of Patients at Skin Mottling Onset

Supplemental Table 1: Characteristics of patients at skin mottling onset.

Variables / Patients with skin mottling (n=230)
Skin mottling at admission, n (%) / 147 (65)
At mottling onset
Mean arterial pressure ≥ 65 mmHg, n (%) / 193 (84)
Vasopressors, n (%) / 73 (32)
Norepinephrine, n (%) / 69 (30
Norepinephrine dose, µg/kg/min, median (IQR) / 0.6 (0.2-1.12)
Epinephrine, n (%) / 12 (5.2)
Epinephrine dose, µg/kg/min, median (IQR) / 0.5 (0.3-2)
Both norepinephrine and epinephrine, n (%) / 8 (3.5)
Mechanical ventilation, n (%) / 136 (59)
Serum lactate level, mmol/l, median (IQR) / 2.3 (1.3-4.4)
Hyperlactatemia ≥ 2 mmol/l, n (%) / 109 (47)

Nominal variables are presented as n (%), continuous variables are presented as median (25th -75th percentile) or mean ± standard deviation according to their distribution using the Kolmogorov-Smirnov test.

Supplemental Table 2: Treatments received during mottling episode.

Variables / Patients with skin mottling
(n=230)
Initiation of vasopressors, n (%) / 20 (8.7)
Initiation of mechanical ventilation, n (%) / 24 (10)
Fluid challenge ≥ 1000 ml, n (%) / 59 (26)

Nominal variables are presented as n (%).

Supplemental Table 3: Univariate analysis of factors associated with in-ICU mortality in the overall population.

Variables / Survivors
(n=675) / Non-survivors
(n=116) / Odds ratio
(95% CI) / p value
Age, years, median (IQR) / 59 (44-70) / 67 (58-77) / 1.035 (1.021-1.048) / < 0.0001
Gender, female, n (%) / 276 (40.89) / 47 (40.52) / 0.985 (0.659-1.471) / 0.94
At admission
Sequential Organ Failure Assessment, median (IQR) / 4 (2-7) / 10 (7-13) / 1.326 (1.258-1.398) / < 0.0001
Simplified Acute Physiology Score II, median (IQR) / 32 (21-45) / 58 (43-69) / 1.067 (1.054-1.081) / < 0.0001
During ICU stay
Use of mechanical ventilation, n (%) / 269 (39.85) / 103 (88.79) / 11.958 (6.581-21.728) / < 0.0001
Use of vasopressors, n (%) / 164 (24.30) / 76 (65.52) / 5.920 (3.884-9.023) / < 0.0001
Use of renal replacement therapy, n (%) / 72 (10.67) / 38 (32.76) / 4.080 (2.580-6.453) / < 0.0001
Occurrence of skin mottling, n (%) / 160 (24) / 70 (60) / 4.898 (3.244-7.397) / < 0.0001

Supplemental Table 4: Univariate analysis of factors associated with in-ICU mortality in the subgroup of patients with skin mottling.

Variables / Survivors
(n=157) / Non-survivors
(n=70) / Odds ratio
(95% CI) / p value
Age, years, median (IQR) / 62 (52-74) / 67 (58-75) / 1.014 (0.994-1.034) / 0.12
Gender, female, n (%) / 51 (32) / 26 (37) / 1.228 (0.682-2.213) / 0.59
Presence of mottling at admission, n (%) / 106 (68) / 41 (59) / 1.470 (0.822-2.629) / 0.23
At admission
Sequential Organ Failure Assessment, median (IQR) / 6 (3-9) / 10 (8-13) / 1.244 (1.153-1.342) / <0.0001
Simplified Acute Physiology Score II, median (IQR) / 39 (29-55) / 56 (43-69) / 1.05 (1.031-1.070) / <0.0001
At mottling onset
Sequential Organ Failure Assessment a, median (IQR) / 4 (2-6) / 8 (5-12) / 1.288 (1.186-1.398) / <0.0001
Use of mechanical ventilation, n (%) / 82 (52) / 54 (77) / 3.087 (1.628-5.853) / 0.0007
Use of vasopressors, n (%) / 31 (20) / 42 (60) / 6.097 (3.283-11.322) / <0.0001
Urinary output, ml/h, median (IQR) / 50 (25-75) / 25 (2-50) / 0.989 (0.982-0.996) / 0.004
Hyperlactatemia ≥ 2 mmol/l, n (%) / 54 (34) / 53 (76) / 5.947 (3.142-11.254) / <0.0001
Persistent skin mottling ≥ 6 hours, n (%) / 81 (52) / 53 (76) / 2.925 (1.558-5.491) / 0.001

a without the neurologic item

Supplemental Figure 1: Kaplan-Meier survival curves according to the time of mottling occurrence. The blue line represents the survival of patients who had mottling at admission. The green line represents the survival of patients who had skin mottling later on their during ICU stay.