ArticlePloS one2024
Shock indices are associated with in-hospital mortality among patients with septic shock and normal left ventricular ejection fraction.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Sepsis prognosis in the emergency department: assessment of shock indices, SOFA, qSOFA, and lactate.International journal of emergency medicine · 2026Article
- Composite shock indices with age, GCS, and SpO2 for trauma triage outcomes: a retrospective cohort study.European journal of medical research · 2025Article
- Prognostic value of novel indices combining Shock Index, Reverse Shock Index, age, and oxygen saturation for predicting mortality in COVID-19 patients in Iran at emergency department triage: a cross-sectional study.Acute and critical care · 2025Article
- Development and assessment of a mortality risk prediction nomogram model for pneumocystis disease in ICU within 28 days.Scientific reports · 2025Article
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Authors and funding
13 authors.
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Abstract
backgroundThe understanding of shock indices in patients with septic shock is limited, and their values may vary depending on cardiac function.
methodsThis prospective cohort study was conducted across 20 university-affiliated hospitals (21 intensive care units [ICUs]). Adult patients (≥19 years) with septic shock admitted to the ICUs during a 29-month period were included. The shock index (SI), diastolic shock index (DSI), modified shock index (MSI), and age shock index (Age-SI) were calculated at sepsis recognition (time zero) and ICU admission. Left ventricular (LV) function was categorized as either normal LV ejection fraction (LVEF ≥ 50%) or decreased LVEF (<50%).
resultsAmong the 1,194 patients with septic shock, 392 (32.8%) who underwent echocardiography within 24 h of time zero were included in the final analysis (normal LVEF: n = 246; decreased LVEF: n = 146). In patients with normal LVEF, only survivors demonstrated significant improvement in SI, DSI, MSI, and Age-SI values from time zero to ICU admission; however, no notable improvements were found in all patients with decreased LVEF. The completion of vasopressor or fluid bundle components was significantly associated with improved indices in patients with normal LVEF, but not in those with decreased LVEF. In multivariable analysis, each of the four indices at ICU admission was significantly associated with in-hospital mortality (P < 0.05) among patients with normal LVEF; however, discrimination power was better in the indices for patients with lower lactate levels (≤ 4.0 mmol/L), compared to those with higher lactate levels.
conclusionsThe SI, DSI, MSI, and Age-SI at ICU admission were significantly associated with in-hospital mortality in patients with septic shock and normal LVEF, which was not found in those with decreased LVEF. Our study emphasizes the importance of interpreting shock indices in the context of LV function in septic shock.
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