A peripheral perfusion index <1.1 before discharge in acute heart failure patients increased the risk of mortality or heart failure hospitalization (HR 2.27; 95% CI 1.55–3.32; p<0.01).
Cohort (n=257)
Does peripheral perfusion index assessment predict the composite of all-cause mortality and hospitalization for worsening HF in patients hospitalized for acute HF?
Assessing perfusion status using peripheral PI before discharge provides a simple method for risk stratification in HF patients with prognostic value comparable to standard clinical criteria.
Effect estimate: HR 2.27 (95% CI 1.55-3.32)
p-value: p=<0.01
Introduction Current heart failure (HF) guidelines recommend hemodynamic assessment based on four clinical profiles: dry-warm, wet-warm, dry-cold, and wet-cold. While physical examination for signs of congestion, e.g., jugular venous distention, is commonly performed, evaluation of perfusion status is often neglected due to the lack of simple and reliable physical indicators. This study aims to evaluate the perfusion index (PI), a noninvasive parameter derived from the ratio of pulsatile to non-pulsatile blood flow components, as a useful tool for assessing perfusion status in patients with HF. Methods This prospective study included 257 patients hospitalized for the management of acute HF. Peripheral PI was measured on the index finger before discharge. The presence or absence of a cold perfusion profile was determined using standard clinical criteria. All patients were followed after discharge. The primary outcome was a composite of all-cause mortality and hospitalization for worsening HF. Results During a mean follow-up of 446 ± 280 days, 109 patients experienced a primary outcome event. Patients with a cold perfusion profile, as defined by standard criteria, had a higher incidence of the primary outcome (hazard ratio 1.98, 95% confidence interval 1.28–2.91, p <0.01), as did those with a peripheral PI <1.1 (hazard ratio 2.27, 95% confidence interval 1.55–3.32, p <0.01). These associations remained consistent across subgroup analyses. Conclusions Assessing perfusion status using peripheral PI before discharge may provide a simple and practical method for risk stratification in patients with HF, offering prognostic value comparable to that of a cold perfusion profile determined by standard clinical criteria.
Kasai et al. (Mon,) conducted a cohort in Acute heart failure (n=257). Peripheral perfusion index (PI) vs. Standard clinical criteria for cold perfusion profile was evaluated on Composite of all-cause mortality and hospitalization for worsening HF (HR 2.27, 95% CI 1.55-3.32, p=<0.01). A peripheral perfusion index <1.1 before discharge in acute heart failure patients increased the risk of mortality or heart failure hospitalization (HR 2.27; 95% CI 1.55–3.32; p<0.01).