# An Observational Study to Correlate Peripheral Perfusion Index as a Predictor of Hypotension and Mortality in Sepsis Patients

## TL;DR

This study shows that the Peripheral Perfusion Index (PPI) can predict hypotension and mortality in sepsis patients better than traditional blood pressure methods, leading to improved outcomes.

## Contribution

The study introduces PPI as a novel predictor for sepsis management, demonstrating its clinical utility over traditional shock criteria.

## Key findings

- PPI-guided therapy reduced hypotension by 28% compared to 50% in traditional methods.
- Mortality decreased to 12.5% with PPI guidance versus 31.3% with standard treatment.
- PPI had strong predictive value with AUROC scores of 0.86 for hypotension and 0.89 for mortality.

## Abstract

Introduction

This observational study explores the Peripheral Perfusion Index (PPI) as a predictor of hypotension and mortality in sepsis. By correlating PPI with clinical outcomes, it assesses its potential for early diagnosis and goal-directed therapy, aiming to improve sepsis management beyond traditional blood pressure-based methods for better patient outcomes.

Objectives

To evaluate the role of the PPI in the early diagnosis and targeted treatment of septic shock, providing insights for improving clinical management and early intervention.

Material and method

This prospective study conducted at a tertiary medical centre, a medical college in Bihar, compares septic shock outcomes between Group 1 (the PPI group), with septic shock diagnosed with PPI <1.4; treatment guided by PPI >2, and Group 2 (the control group), diagnosed by traditional shock criteria (systolic blood pressure <90 mmHg or >40 mmHg drop from baseline) with standard bundle treatment.

Result

PPI-guided therapy significantly improved hemodynamic stabilization, reduced hypotension (28% vs. 50%), decreased mortality (12.5% vs. 31.3%), and shortened ICU stays (5 ± 2 vs. 8 ± 3 days) compared to traditional shock criteria. PPI demonstrated strong predictive value for hypotension (area under the receiver operating characteristic curve (AUROC) 0.86) and mortality (AUROC 0.89), supporting its clinical utility in sepsis.

Conclusion

This study confirms PPI's reliability in septic shock management, advocating a shift from mean arterial pressure (MAP)-focused to PPI-guided therapy for better outcomes.