Peripheral Perfusion Index Predicts Transfusion Need in Upper Gastrointestinal Bleeding: A Prospective Observational...

Area of Science:

• Emergency Medicine
• Critical Care
• Gastroenterology

Background:

• Upper gastrointestinal bleeding (UGIB) is a critical emergency requiring prompt assessment of transfusion needs and hypovolemia.
• Conventional risk scores often depend on delayed laboratory and endoscopy results, hindering timely intervention.

Purpose of the Study:

• To evaluate the prognostic value of the peripheral perfusion index (PPI) in predicting blood transfusion requirements and hypovolemic shock in UGIB patients.
• To compare the predictive accuracy of PPI against established markers like shock index and lactate levels.

Main Methods:

• A prospective observational study involving 134 adult UGIB patients in a tertiary emergency department.
• Peripheral perfusion index (PPI) was measured after a rest period.
• Outcomes included transfusion requirement and hypovolemic shock; predictive performance was assessed using ROC analysis and logistic regression.

Main Results:

• A PPI <1.0 was observed in 49.3% of patients and was significantly associated with higher transfusion rates (71.2% vs. 27.9%) and mortality (21.2% vs. 8.8%).
• PPI <1.0 independently predicted transfusion need (OR: 7.68) and demonstrated superior accuracy (AUC=0.771) compared to shock index (AUC=0.750), lactate (AUC=0.628), and base deficit (AUC=0.682).

Conclusions:

• A peripheral perfusion index (PPI) <1.0 is a robust, independent predictor of transfusion requirements in UGIB patients.
• PPI offers a rapid, non-invasive bedside method for identifying high-risk patients, facilitating timely clinical decisions.