Background: Fluid resuscitation is the recommended management of shock but increased mortality in febrile African children in the FEAST trial. Methods: We developed scores for respiratory, cardiovascular and neurological function using vital sign data. These scores were used to compare FEAST subjects with four other cohorts. Scores, haemoglobin and plasma biochemistry were compared in patients randomised to receive albumin or saline bolus (n=2097) or no bolus (n=1044), and used in Bayesian Dirichlet process clustering to identify subgroups within FEAST. Their combined contributions to bolus-induced deaths in FEAST were assessed through comparison of Cox proportional hazard models. Findings: Increasing respiratory, neurological and cardiovascular scores were associated with death in FEAST (all p