The following is a summary of “Prolonged capillary refill time and short-term mortality of critically ill patients: A meta-analysis,” published in the May 2024 issue of Emergency Medicine by Wang, et al.
Extended capillary refill time (CRT) is an indicator of compromised peripheral perfusion. In a systematic review and meta-analysis, researchers sought to assess the correlation between prolonged CRT and mortality among patients with critical Illness.
A comprehensive search of PubMed, Embase, Cochrane Library, and the Web of Science was conducted to identify relevant longitudinal observational studies. Between-study heterogeneity was evaluated using the Cochrane Q test, with the I2 statistic estimating heterogeneity extent. Random-effects models were applied to combine outcomes, considering potential heterogeneity impact.
Eleven studies involving 11,659 patients with critical Illness were analyzed. Over follow-up durations ranging from hospitalization to 3 months, 1,247 (10.7%) patients succumbed. Pooled results revealed a significant association between prolonged CRT upon admission and elevated all-cause mortality risk (risk ratio [RR]: 1.73, 95% CI: 1.39 to 2.16, P < 0.001; I2 = 60%). Subgroup analyses indicated that this association remained consistent across study design (prospective or retrospective), disease etiology (infection, non-infection, or mixed), and CRT cutoff (>3 s, 3.5 s, or 4 s). Notably, studies employing multivariate analysis demonstrated a weaker association between CRT and mortality (RR: 1.43, 95% CI: 1.27 to 1.60, P < 0.001; I2 = 0%) compared to those employing univariate analysis (RR: 6.27, 95% CI: 3.29 to 11.97, P < 0.001; I2 = 0%).
Prolonged CRT upon admission may serve as a predictor for increased short-term mortality among patients with critical Illness.
Reference: sciencedirect.com/science/article/abs/pii/S073567572400055X
