The following is a summary of Prognostic value of capillary refill time in adult patients: a systematic review with meta-analysis?,” published in the December 2023 issue of Critical Care by Lagreze et al.

Despite its widespread use, the prognostic value of capillary refill time (CRT) in acute circulatory failure remains controversial.

Researchers performed a retrospective study to evaluate the predictive ability of CRT for mortality and adverse events in adults with suspected or confirmed acute circulatory failure.

They screened MEDLINE, EMBASE, and Google Scholar for relevant studies. Determining the pooled area under the ROC curve (AUC ROC), sensitivity, specificity, threshold, and diagnostic odds ratio using a random-effects model, they focused on the primary analysis of abnormal CRT’s ability to predict death in patients with acute circulatory failure. Secondary analysis assessed CRT’s ability to predict adverse outcomes, compared its efficacy to lactate, and explored factors influencing accuracy.

The results showed 60,656 patients in 23 studies. In the primary analysis, the pooled AUC ROC for 13 studies was 0.66 (95%CI [0.59; 0.76]), with pooled sensitivity at 54% (95%CI [43; 64]) and pooled specificity at 72% (95%CI [55; 84]). The pooled diagnostic OR was 3.4 (95%CI [1.4; 8.3]). In the secondary analysis, the pooled AUC ROC for 23 studies was 0.69 (95%CI [0.65; 0.74]). The prognostic value of CRT was similar to lactate, and high-quality CRT was more accurate.

They concluded that CRT had limited predictive value for mortality and adverse events in acute circulatory failure patients; high-quality CRT measurement improved accuracy.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-023-04751-9