Capillary Refill Time for Prognostic Assessment of Patients with Sepsis: A Prospective Cohort Study

Abstract Background Sepsis is a life-threatening condition characterized by organ dysfunction due to a dysregulated host response to infection. Although macrohemodynamic parameters often normalize with treatment, microcirculatory disturbances may persist. Capillary refill time (CRT) has emerged as a simple bedside indicator of microcirculatory perfusion; however, its dynamic prognostic value over time remains underexplored. Aim This study aimed to observe the changes in CRT in patients with sepsis and to evaluate its predictive value at different time points. Study Design: This prospective observational study enrolled patients diagnosed with sepsis at the Center of Critical Care Medicine, First Affiliated Hospital of Xinjiang Medical University, between March 2024 and March 2025. The data collected included patient demographics, CRT, lactatetate (lactate) levels, and central venous pressure (CVP) at baseline and at 1, 3, 6, 12-, 24-, 48-, and 72-hours post-treatment. Prognostic indicators included vasoactive drug dose, ICU stay, mechanical ventilation duration, Acute Physiology and Chronic Health Evaluation II (APACHE II), and Sequential Organ Failure Assessment (SOFA) scores. Patients were grouped based on their 28-day survival outcomes. Intergroup comparisons and correlations between CRT and lactate/CVP were performed. The predictive value of CRT was assessed using receiver operating characteristic (ROC) curves. Results Eighty-six patients were included (70 survivors and 16 non-survivors). The non-survival group had significantly higher lactate and SOFA scores, higher vasoactive drug doses, and longer CRTs (P < 0.05). CRT was significantly correlated with lactate and CVP levels. The 3-hour CRT had the highest predictive value (sensitivity, 93.8%; specificity, 97.1%; AUC, 0.981). Conclusion CRT is a valuable prognostic marker in sepsis, with a 3-hour CRT offering the strongest predictive performance. CRT monitoring may guide early treatment decisions in the management of sepsis.