Association of Early Peripheral Perfusion Parameters with Organ Dysfunction and Mortality in Critically Ill Patients with Circulatory Shock: A Prospective Observational Study
Keywords:
Circulatory Shock, Capillary Refill Time, Mottling, Peripheral Perfusion Index, Sofa.Abstract
Background: Peripheral perfusion abnormalities may provide early information about tissue hypoperfusion in circulatory shock. This study evaluated whether capillary refill time (CRT), mottling, and peripheral perfusion index (PI) were associated with organ dysfunction and mortality.
Methods: In this prospective observational study, 200 adults with circulatory shock underwent baseline and six-hour peripheral perfusion assessment. Associations with 48-hour SOFA score and 28-day mortality were examined using adjusted regression models.
Results: Twenty-eight-day mortality was 24.0%. Baseline CRT was associated with mortality in unadjusted analysis but not after adjustment (OR 1.40 per second, 95% CI 0.92–2.14). Baseline mottling and PI were also not independently associated with mortality. In contrast, six-hour worsening in CRT and mottling was associated with higher 48-hour SOFA scores (β=1.47 and 0.82, respectively), while improvement in PI was associated with lower SOFA (β=−0.65; all p≤0.001).
Conclusion: Early changes in peripheral perfusion were more strongly associated with evolving organ dysfunction than baseline values alone.
