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2026, Number 4

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Med Crit 2026; 40 (4)

Shock indices and lactate in septic shock: correlation and linear regression analysis in a retrospective study

Arellano JRJ, Mendoza PE, Lozano NJJ, Ayala PJA, Estrada GMN

Language: Spanish
References: 29
Page: 316-325
PDF size: 834.86 Kb.


ABSTRACT

Introduction: serum lactate is the most widely used marker for identifying hypoperfusion in sepsis, although it has limitations. Shock indices are potentially useful non-invasive tools for estimating hemodynamic instability. The objective was to evaluate the correlation between the diastolic shock index (DSI) and lactate levels in patients with septic shock and to compare its performance with other shock indices. Material and methods: a multicenter, retrospective, analytical study was conducted in 41 patients with septic shock treated between 2022 and 2024. The shock index (SI), DSI, modified shock index (MSI), age-adjusted shock index (ASI), and pulse pressure (PP) were calculated. The association with lactate was analyzed using Spearman correlation and bivariate linear regression with logarithmic transformation of lactate. Results: the median lactate level was 2 mmol/L (IQR 1.3-3.5), and the in-hospital mortality rate was 39%. The ICD showed a weak positive correlation with lactate (0.322; p < 0.04; R2: 0.104). The IC showed the strongest correlation (0.494; p ≤ 0.001), while the ICE showed the greatest explanatory power (R2: 0.285). The PP showed no medicinacriticasignificant association. Discussion and conclusions: the ICD showed a limited association with lactate levels. The IC and, especially, the ICE showed better statistical performance. Shock indices can complement the initial assessment of patients with septic shock, but they do not replace biochemical markers. Prospective studies with larger sample sizes are needed to validate these findings.


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