The role of peripheral perfusion index measurement in predicting hypovolemic shock and blood transfusion need in patients with upper gastrointestinal bleeding in the emergency department; prospective, observational study

Yatmazoglu Aki, Z. The Role of Peripheral Perfusion Index Measurement in Predicting Hypovolemic Shock and Blood Transfusion Need in Patients with Upper Gastrointestinal Bleeding in the Emergency Department; Prospective, Observational Study Eskisehir Osmangazi University Faculty of Medicine, Department of Emergency Medicine, Residency Thesis, Eskisehir, 2024. Studies have developed many clinical scoring systems for transfusion needs and mortality in patients with gastrointestinal bleeding. To reduce mortality in gastrointestinal bleeding, critical patients must be identified early. Based on this information, we aimed to detect the patient in shock early and predict the need for transfusion by measuring PI in patients with upper gastrointestinal bleeding in the emergency department. The study is single-center, prospective and observational. Eskisehir Osmangazi University Clinical Research Ethics Committee approval was approval was obtained. A total of 134 patients diagnosed with upper gastrointestinal bleeding, aged 18 and over, were included in the study. Demographic characteristics, comorbid diseases, vital signs, laboratory data, transfusion record, endoscopy findings, shock index and PI values of the patients were recorded. We found that the need for blood transfusion in the emergency department (p<0.001) and in-hospital mortality (p>0.044) were higher in 66 patients with PI<1. In the ROC analysis performed to determine the need for blood transfusion in the emergency department, we found that PI was more significant than shock index, lactate and base deficit measurements in predicting the need for transfusion (AUC and p values: 0.771 for PI, p<0.0001). This shows that, thanks to PI measurements, it may be possible to triage patients more quickly and effectively, detect critically ill patients early, and predict the need for transfusion. Key Words: Upper gastrointestinal bleeding, Shock, Blood Transfusion, Perfusion Index