Similarly, a decreased CD4+/CD8+ ratio reflects T-cell dysfunction and imbalance, which has been directly linked to poor outcomes and encephalopathy in sepsis.[33,37] While others have noted immune dysregulation in sepsis broadly, our study novelly identifies this specific triad of immunological markers (IFN-γ, TNF-α, CD4+/CD8+ ratio) as a key and independent predictor of SAE, moving beyond mere association to propose a actionable predictive tool. Here, TNF is linked to Encephalopathy.