Correlation of Shock-Lactate Index with 28-Day Mortality in Patients Experiencing Sepsis-Related AKI: An Analysis Using the MIMIC-IV Database - Scorecard - MDSpire
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Correlation of Shock-Lactate Index with 28-Day Mortality in Patients Experiencing Sepsis-Related AKI: An Analysis Using the MIMIC-IV Database
Clinical Scorecard: Correlation of Shock-Lactate Index with 28-Day Mortality in Patients Experiencing Sepsis-Related AKI: An Analysis Using the MIMIC-IV Database
At a Glance
Category
Detail
Condition
Sepsis-associated acute kidney injury (SA-AKI)
Key Mechanisms
Shock index (heart rate/systolic blood pressure) combined with lactate level to detect occult circulatory failure and predict mortality
Target Population
Adult ICU patients with sepsis and AKI
Care Setting
Intensive Care Unit (ICU)
Key Highlights
Sepsis-associated AKI occurs in up to 60% of sepsis cases and significantly increases mortality.
Shock index (SI) and lactate levels individually predict mortality; their combination as Shock-Lactate Index (SLI) may improve early detection of circulatory failure.
SLI is investigated as an independent predictor of 28-day mortality in SA-AKI patients using MIMIC-IV ICU data.
Guideline-Based Recommendations
Diagnosis
Use Sepsis-3 criteria (infection plus SOFA score ≥ 2) to identify sepsis.
Diagnose AKI using KDIGO criteria after ICU admission.
Calculate Shock Index (heart rate/systolic blood pressure) and measure lactate within 24 hours of ICU admission.
Management
Early recognition of shock using SLI to guide timely resuscitation and intervention.
Monitor hemodynamic status and tissue perfusion closely in SA-AKI patients.
Monitoring & Follow-up
Dynamic monitoring of lactate levels, especially within the first 12 hours, to identify high-risk patients.
Regular assessment of vital signs to calculate shock index and SLI.
Risks
Delayed recognition of occult circulatory failure may worsen prognosis.
High SLI values correlate with increased 28-day mortality risk.
Patient & Prescribing Data
Adult ICU patients with sepsis-associated AKI
SLI measurement within 24 hours of ICU admission aids in risk stratification and may inform early clinical decision-making to improve outcomes.
Clinical Best Practices
Employ combined Shock-Lactate Index (SLI) for early detection of occult shock in sepsis-related AKI.
Use validated criteria (Sepsis-3, KDIGO) for accurate diagnosis and staging.
Integrate SLI with other clinical scores (SOFA, SAPSII) to enhance prognostic accuracy.
Ensure timely data collection of vital signs and lactate levels within 24 hours of ICU admission.
