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Diagnosis of RSS with bSSS and cSSS had a high discrimination for death with an area under the receiver operating curve of 0.916 [95% CI 0.843-0.990] and 0.925 [95% CI 0.845-1.000], respectively. High prognostic accuracy of the bSSS was found in the first hours following intensive care admission. The best interval of prognostication occurs after the 12th hour following treatment initiation (AUC 0.973 [95% CI 0.925-1.000]). The ESPNIC refractory septic shock definition accurately identifies, within the first 6h of septic shock management