Observational studyBritish journal of anaesthesia2021
Association of the intraoperative peripheral perfusion index with postoperative morbidity and mortality in acute surgical patients: a retrospective observational multicentre cohort study.
Observational study in British journal of anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Fluid Administered According to Plethysmographic Variability Index Versus Ideal Fluid Management in Laparoscopic Trendelenburg Surgeries
Association Between Intraoperative Perfusion Index and Mortality
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Analysis of perioperative corticosteroid therapy in children undergoing cardiac surgery: A systematic review and meta-analysis.Clinical cardiology · 2023Pooled it
- Assisted Fluid Management and Sublingual Microvascular Flow During High-Risk Abdominal Surgery: A Randomized Controlled Trial.Anesthesia and analgesia · 2025Trial
- Association between peripheral perfusion index and postoperative acute kidney injury in major noncardiac surgery patients receiving continuous vasopressors: a post hoc exploratory analysis of the VEGA-1 trial.British journal of anaesthesia · 2024Trial
- Associations between clinical interventions and transcutaneous blood gas values in postoperative patients.Journal of clinical monitoring and computing · 2023Trial
- To identify normovolemia in humans: The stroke volume response to passive leg raising vs. head-down tilt.Physiological reports · 2022Trial
- Development and internal validation of the Low Cardiac Index Score: a simplified bedside tool for continuous intraoperative screening.Journal of clinical monitoring and computing · 2026Article
- Prognostic Factors for Postoperative Complications. An Aggregate Protocol for 10 Observational Studies From the Danish TRIPLE-A Cohort of 1.2 Million Surgeries.Acta anaesthesiologica Scandinavica · 2026Article
- Automated hemodynamic management system for the prevention of hypotension and cardiac output reduction during general anesthesia: preclinical experimental validation.Journal of anesthesia · 2026Article
- Intraoperative blood pressure management in noncardiac surgery: a narrative review based on current evidence.Intensive care medicine · 2026Review
- Access to haemodynamic evaluation tools in middle-income countries: a survey of 1593 anaesthetists and intensivists from 39 nations.BJA open · 2026Article
- The reliability of the plethysmographic perfusion index for detecting fluid responsiveness in critically ill patients.Journal of intensive medicine · 2026Article
- Thermal intervention improves pulse oximetry accuracy in critically ill patients with low perfusion: a quasi-experimental study.Journal of intensive care · 2026Article
- Impaired peripheral perfusion during anesthesia is associated with postoperative delirium in older patients undergoing minimally invasive colorectal surgery: a retrospective observational study.Frontiers in medicine · 2026Article
- Noninvasive predictive value of preoperative perfusion index for intraoperative hemodynamic fluctuations in patients undergoing lower-extremity orthopedic surgery under regional anesthesia: a retrospective cohort study.Frontiers in surgery · 2026Article
- Article
- Non-Invasive Hemodynamic Monitoring System Integrating Spectrometry, Photoplethysmography, and Arterial Pressure Measurement Capabilities.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Article
- Early peripheral perfusion index predicts 28-day outcome in patients with septic shock.World journal of emergency medicine · 2024Article
- "The peripheral perfusion index discriminates haemodynamic responses to induction of general anaesthesia".Journal of clinical monitoring and computing · 2023Article
- Is handheld video microscopy really the future of microcirculation monitoring?Critical care (London, England) · 2023Article
- Association of the perfusion index with postoperative acute kidney injury: a retrospective study.Korean journal of anesthesiology · 2023Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe hypothesised that in acute high-risk surgical patients, a lower intraoperative peripheral perfusion index (PPI) would indicate a higher risk of postoperative complications and mortality.
methodsThis retrospective observational study included 1338 acute high-risk surgical patients from November 2017 until October 2018 at two University Hospitals in Denmark. Intraoperative PPI was the primary exposure variable and the primary outcome was severe postoperative complications defined as a Clavien-Dindo Class ≥III or death, within 30 days.
resultsintraoperative PPI was associated with severe postoperative complications or death: odds ratio (OR) 1.12 (95% confidence interval [CI] 1.05-1.19; P<0.001), with an association of intraoperative mean PPI ≤0.5 and PPI ≤1.5 with the primary outcome: OR 1.79 (95% CI 1.09-2.91; P=0.02) and OR 1.65 (95% CI 1.20-2.27; P=0.002), respectively. Each 15-min increase in intraoperative time spend with low PPI was associated with the primary outcome (per 15 min with PPI ≤0.5: OR 1.11 (95% CI 1.05-1.17; P<0.001) and with PPI ≤1.5: OR 1.06 (95% CI 1.02-1.09; P=0.002)). Thirty-day mortality in patients with PPI ≤0.5 was 19% vs 10% for PPI >0.5, P=0.003. If PPI was ≤1.5, 30-day mortality was 16% vs 8% in patients with a PPI >1.5 (P<0.001). In contrast, intraoperative mean MAP ≤65 mm Hg was not significantly associated with severe postoperative complications or death (OR 1.21 [95% CI 0.92-1.58; P=0.2]).
conclusionsLow intraoperative PPI was associated with severe postoperative complications or death in acute high-risk surgical patients. To guide intraoperative haemodynamic management, the PPI should be further investigated.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.