ArticleClinical and experimental emergency medicine2022
Prediction of vasopressor requirement among hypotensive patients with suspected infection: usefulness of diastolic shock index and lactate.
Article in Clinical and experimental emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Early management of adult sepsis and septic shock: Korean clinical practice guidelines.Acute and critical care · 2024Guideline
- Admission shock indices and lactate for mortality risk stratification in non-traumatic hypotensive patients.Irish journal of medical science · 2026Article
- From Static Risk Estimates to Dynamic Clinical Trajectories: A Conceptual Analysis of Perioperative Medicine.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Temporal Analysis of Diastolic Shock Index in Patients with Septic Shock and Its Correlation with Clinical Outcomes in an Indian Setting: A Prospective Observational Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Beyond the Mean: The Dynamic Fingerprint of Vasoplegia in Septic Shock.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Effect of norepinephrine initiation timing on mortality in septic shock: a multicenter cohort study.BMC anesthesiology · 2026Observational
- Predicting Cardiovascular Collapse in Critically Ill Patients During Intubation Induction: A Prospective Observational Study.Medicina (Kaunas, Lithuania) · 2026Observational
- A Novel Approach to Early Personalized Hemodynamic Resuscitation: Non-Invasive Peripheral Photoplethysmography for Identifying Predominant Vasodilatory Shock in Sepsis.Acta anaesthesiologica Scandinavica · 2025Article
- A Simple Bacteremia Score for Predicting Bacteremia in Patients with Suspected Infection in the Emergency Department: A Cohort Study.Journal of personalized medicine · 2023Article
- Modified Cardiovascular Sequential Organ Failure Assessment Score in Sepsis: External Validation in Intensive Care Unit Patients.Journal of Korean medical science · 2023Observational
- Prognostic Accuracy of SpOThe western journal of emergency medicine · 2023Article
- Prognostic accuracy of initial and 24-h maximum SOFA scores of septic shock patients in the emergency department.Heliyon · 2023Article
- Hemodynamic management of septic shock: beyond the Surviving Sepsis Campaign guidelines.Clinical and experimental emergency medicine · 2023Article
- Using the diastolic shock index to determine when to promptly administer vasopressors in patients with septic shock.Clinical and experimental emergency medicine · 2022Article
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Authors and funding
12 authors at 1 institution in 1 country.
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Abstract
objectiveWe evaluated the performance of diastolic shock index (DSI) and lactate in predicting vasopressor requirement among hypotensive patients with suspected infection in an emergency department.
methodsThis was a single-center, retrospective observational study for adult patients with suspected infection and hypotension in the emergency department from 2018 to 2019. The study population was split into derivation and validation cohorts (70/30). We derived a simple risk score to predict vasopressor requirement using DSI and lactate cutoff values determined by Youden index. We tested the score by the area under the receiver operating characteristic curve (AUC). We performed a multivariable regression analysis to evaluate the association between the timing of vasopressor treatment and 28-day mortality.
resultsA total of 1,917 patients were included. We developed a score, assigning 1 point each for the high DSI (≥2.0) and high lactate (≥2.5 mmol/L) criteria. The AUCs of the score were 0.741 (95% confidence interval [CI], 0.715-0.768) at hypotension and 0.736 (95% CI, 0.708-0.763) after initial fluid challenge in the derivation cohort and 0.676 (95% CI, 0.631-0.719) at hypotension and 0.688 (95% CI, 0.642-0.733) after initial fluid challenge in the validation cohort, respectively. In patients with scores of 2 points, early vasopressor therapy initiation was significantly associated with decreased 28-day mortality (adjusted odds ratio, 0.37; 95% CI, 0.14-0.94).
conclusionA prediction model with DSI and lactate levels might be useful to identify patients who are more likely to need vasopressor administration among hypotensive patients with suspected infection.
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