The prognostic value of non-invasive perfusion index measurement in critically ill patients presenting to an adult emergency department

Objectives Critically ill patients, with higher mortality and hospital admission rates, are the kind that have to be early recognised and treated promptly. The aim of our study was to investigate the demographic properties of patients presenting to our emergency department (ED) and to find out the factors influencing the survival. Methods The study was carried out in The Emergency Department of Akdeniz University Hospital which has 72800 annual ED visits. 770 patients [16years ? , 291 (37,8%) female, 479 (62,2%) male] who were taken care in critical care area of the ED were enrolled into our study. Demographics, vital signs, prognosis, ED length of stay, 30 day mortality rates were recorded and followed. Systolic blood pressure, diastolic blood pressure, pulse rate, pespiratory rate, body temperature, pulse oxymeter and perfusion index measurement were recorded as vital parameters. Results 192 (24,9%) patients had diabetes mellitus, 118 (15,3%) patients had malignancy, 292 (37,9%) patients had hypertension diagnosis, 202 (26,2%) patients had coronary heart disease. Of those patients 21 (2,7%) were hypotensive and 34 (4,4%) had fever. 278 (36,1%) patients were admitted to the hospital, 454 (59%) patients were discharged, 3 (0,4%) patients died in the ED, 25 (3,2%) patients were transferred to another hospital, 10 (1,3%) patients refused treatment and left the ED. 60 (7,8%) patients, 39 (5,1%) of whom had died in 15 days? period, were dead at the end of 30-day follow up period. ?Respiratory rate? (p=0,000) and ?pulse oxymeter? (p=0,000) were significant in hospital admission. ?Systolic blood pressure? (p=0,001), ?diastolic blood pressure? (p=0,04), ?pulse rate? (p=0,007), ?respiratory rate? (p=0,000), ?pulse oxymeter? (p=0,000), ?lactat levels in blood gase analysis? (p=0,000) and ?ED length of stay? (p=0,017) had significant values in 30-days mortality rate. Patients who were admitted to the hospital had higher rates of ?fever? (p=0,000) and ?DM? (p=0,023). Patients who had died in the 30-day follow up period had higher rates of ?DM? (p=0,029) and ?malignancy? (p=0,000). In logistic regression analysis the predictors of hospital admission were ?hypotension? (p=0,046), ?fever? (p=0,021) and ?pulse oxymeter? (p=0,000) while the predictors of mortality in 30-days follow up period were ?systolic blood pressure? (p=0,008), ?respiratory rate? (p=0,002), ?pulse oxymeter? (p=0,020) and ?presence of malignancy? (p=0,000). Conclusion Critically ill patients of EDs have high mortality rates in 30-days follow up. Each one of the vital parameters are independent indicators in predicting mortality in 30 days. But PI is not a useful tool as a predictor of prognosis. The patients who have diabetes mellitus or malignancy should be carefully evaluated.