The role of perfusion index in the evaluation of patients with cancer

Comprehensive Summary

The goal of this study was to assess the effectiveness of application of the perfusion index in predicting 30-day mortality rates for cancer patients admitted to the emergency department. This retrospective study catalogued cancer patient’s clinical and laboratory metrics, as well as their perfusion index at presentation to the emergency department. Following this, every patient’s emergency severity index and sequential organ failure assessment quantitative measurements were computed. 208 total patients were involved in the study. The reported 30 day mortality rate included 77 patients (37%). Patients recording ESI-1,2 possessed a 6.26 fold mortality rate (OR: 6.258). The perfusion index was not indicative of mortality rate. However, sequential organ failure assessment values over 2 were predictive of mortality rate (74.3% AUC, 54.55% sensitivity, 87.79% specificity). The study found that perfusion index was a poorer indicator of 30-day mortality rate prediction than both emergency severity index and sequential organ failure assessment.

Outcomes and Implications

Cancer patients seeking care at the emergency department often present with a myriad of complicated and life-threatening symptoms. Urgent and intentional triaging can provide information necessary for improved treatment outcomes and clinical care. It is imperative that diagnostic tests and scoring are representative of probable outcomes and are able to inform clinicians about patients outcomes and possible treatment plans. The confirmation that perfusion index is not a strong indicator of 30-day mortality rate, unlike emergency severity index or sequential organ failure assessment can inform clinical decision making so that physicians can preferentially judge 30-day mortality rate on other factors.