title: Capillary refill time is a predictor of short-term mortality for adult patients admitted to a medical department: an observational cohort study.
abstract: BACKGROUND
  Capillary refill time (CRT) has been advocated as a tool for rapid assessment of circulatory status. The correlation between neither CRT and mortality nor CRT and markers of circulatory status has been assessed. We performed a prospective observational cohort study to assess the relationship between CRT (using two existing definitions and as a continuous variable) and short-term mortality.
  
  
  METHODS
  We included all acutely admitted adult patients to a medical admission unit. We measured CRT, blood pressure, pulse, temperature and peripheral oxygen saturation. We presented the data descriptively. Difference between continuous data was analysed using Wilcoxon Rank Sum Test and categorical data using χ(2) test. The primary endpoint was 1-day all-cause mortality.
  
  
  RESULTS
  3046 patients were enrolled and CRT was measured on 1935. In univariate analyses, we found increasing all-cause 1-day mortality with all definitions of CRT. Performing multivariable analysis, controlling for age, sex, mean blood pressure, pulse, temperature and peripheral oxygen saturation, we found increasing CRT as a continuous variable and according to the Schriger and Baraff definition to be associated with increased mortality. Both the Trauma score and Schriger and Baraff definitions had high negative predictive values. The calculations on the Schriger and Baraff definition were based on limited power.
  
  
  CONCLUSIONS
  We found a significant association between CRT measured as a continuous variable and short-term mortality. Using the definition of Schriger and Baraff also seems appropriate, but this is based on calculations of limited power.
authors.affiliation: Department of Cardiology, Sydvestjysk Sygehus Esbjerg, Esbjerg, Denmark.
authors.forename: Monija
authors.initials: M
authors.lastname: Mrgan
authors.affiliation: Department of Medicine, Sygehus Lillebælt Fredericia, Denmark.
authors.forename: Dorte
authors.initials: D
authors.lastname: Rytter
authors.affiliation: Department of Cardiology, Sydvestjysk Sygehus Esbjerg, Esbjerg, Denmark.
authors.forename: Mikkel
authors.initials: M
authors.lastname: Brabrand
mesh_terms: D000208:Acute Disease; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002200:Capillary Resistance / Q000502:physiology*; D002423:Cause of Death; D015331:Cohort Studies; D003718:Denmark; D004636:Emergency Service, Hospital; D005260:Female; D006339:Heart Rate / Q000502:physiology; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D010343:Patient Admission; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013997:Time Factors
keywords: acute medicine-other; death/mortality