Prognostic performance of peripheral perfusion index and shock index combined with ESI to predict hospital outcome.

Daş M., Bardakci O., Siddikoglu D., Akdur G., Yilmaz M. C., Akdur O., ...More

The American journal of emergency medicine, vol.38, pp.2055-2059, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 38
  • Publication Date: 2020
  • Doi Number: 10.1016/j.ajem.2020.06.084
  • Journal Name: The American journal of emergency medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Agricultural & Environmental Science Database, Biotechnology Research Abstracts, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.2055-2059
  • Keywords: Emergency severity index, Peripheral perfusion index, Shock index, Hospital outcome, Mortality, EMERGENCY SEVERITY INDEX, TRIAGE, MORTALITY, RELIABILITY
  • Çanakkale Onsekiz Mart University Affiliated: Yes


Introduction: Peripheral perfusion index (PPI) and shock index (SI) are considered valuable predictors of hospital

outcome and mortality in various operative and intensive care settings. In the present study, we evaluated the

prognostic capabilities of these parameters for performing emergency department (ED) triage, as represented

by the emergency severity index (ESI).

Methods: This prospective cross-sectional study included 367 patients aged older than 18 years who visited the

ED of a tertiary referral hospital. The ESI triage levels with PPI, SI, and other basic vital sign parameters were recorded

for each patient. The hospital outcome of the patients at the end of the ED period, such as discharge, admission

to the hospital and death were recorded.

Results: A total of 367 patients (M/F: 178/189) admitted to the EDwere categorized according to ESI and included

in the study. A decrease in diastolic BP, SpO2 and PPI increased the likelihood of hospitalization and 30-day mortality.

Based on univariate analysis, a significant improvement in performance was found by using age, diastolic

BP, mean arterial pressure, SpO2, SI and PPI in terms of predicting high acuity level patients (ESI < 3). In the

multivariable analysis only SpO2 and PPI were found to predict ESI < 3 patients.

Conclusion: Peripheral perfusion index and SI as novel triage instruments might provide useful information for

predicting hospital admission and mortality in ED patients. The addition of these parameters to existing triage

instruments such as ESI could enhance the triage specificity in unselected patients admitted to ED.