What question did this study set out to answer?

To assess the changes in capillary refill time (CRT) in sepsis patients and its prognostic value over time.

February 5, 2026

The Prognostic Value of Capillary Refill Time in Patients With Sepsis: A Prospective Cohort Study

Key Points

To assess the changes in capillary refill time (CRT) in sepsis patients and its prognostic value over time.
Conducted a prospective cohort study with sepsis patients receiving bundle therapy.
Measured CRT, lactate (Lac), and central venous pressure (CVP) at eight time points from pre-treatment to 72 hours.
Divided patients by 28-day survival to compare parameters using inter-group and intra-group analyses.
Employed Spearman's correlation to assess CRT correlations with Lac and CVP and performed ROC analysis for predictive value.
Of 86 patients, 70 survived and 16 did not, with significant inter-group differences in age, SOFA score, lactate, and drug dosage.
CRT and Lac showed significant differences between groups at all time points, while CVP varied at specific intervals.
In survivors, CRT negatively correlated with CVP; in non-survivors, CRT positively correlated with Lac and negatively with CVP.
ROC analysis revealed that CRT measured 3 hours post-treatment had the highest predictive value, with AUC of 0.981 and high sensitivity and specificity.

Abstract

ABSTRACT Background Sepsis is life‐threatening due to organ dysfunction from a dysregulated host response. Despite macrohemodynamic stabilisation, microcirculatory disturbances may persist. Capillary refill time (CRT) is a simple bedside indicator of microcirculatory perfusion, but its dynamic prognostic value over time is underexplored. Aim To observe CRT changes in sepsis patients and evaluate its predictive value at different time points. Study Design This prospective cohort study enrolled sepsis patients receiving bundle therapy at a single centre. Patients were grouped by 28‐day survival. Baseline data, CRT, lactate (Lac) and central venous pressure (CVP) were measured at eight time points (pre‐treatment to 72 h) compare inter‐group and intra‐group differences. Spearman's correlation assessed CRT‐Lac/CVP relationships. ROC analysis evaluated CRT's prognostic value. Results Of 86 patients (70 survived, 16 non‐survivors), significant inter‐group differences ( p < 0.05) were found in age, SOFA score, lactate and vasoactive drug dosage. CRT and Lac differed significantly between groups at all time points ( p < 0.05), while CVP differed at 3, 24 and 72 h. Intra‐group comparisons showed significant changes in all parameters over time ( p < 0.01). CRT correlated negatively with CVP in survivors ( r = −0.358, p < 0.001). In non‐survivors, CRT positively correlated with Lac and negatively with CVP ( r = 0.416 and −0.553, both p < 0.001). ROC analysis indicated 3‐h post‐treatment CRT had the highest predictive value (AUC = 0.981, sensitivity 93.8%, specificity 97.1%). Spearman correlation analysis revealed a positive correlation between ΔCRT₃h and ΔLac₃h in both patient groups: ρ = 0.25, p = 0.035 in the survival group and ρ = 0.52, p < 0.001 in the non‐survival group. Conclusions CRT is a valuable prognostic marker in sepsis, with 3‐h CRT showing the strongest predictive performance. Its monitoring may guide early treatment decisions. Relevance to Clinical Practice This study validates nurse‐measured capillary refill time (CRT) as a simple, early‐warning tool. A prolonged 3‐h CRT accurately identifies high‐risk septic patients, enabling nurses to prioritise care and guide timely resuscitation at the bedside.

Ask AI

Helpful

Bookmark