TEG Lysis Shutdown Represents Coagulopathy in Bleeding Trauma Patients
Notice bibliographique
Résumé
Plain Language Summary Background: Despite advances in intensive care, sepsis and septic shock still have high morbidity and mortality. Microcirculatory disturbance is a key issue in sepsis, leading to hypoperfusion, hypoxia, and organ failure. The skin is a sensitive indicator of microcirculatory changes and often shows early systemic changes. Recently, bedside skin perfusion indicators such as the Mottling score (MS), Capillary Refill Time (CRT), and Peripheral Perfusion Index (PPI) have become common in practice. However, their value in predicting outcomes lacks strong evidence. Methods: A systematic search was conducted across databases, including PubMed, Web of Science, Cochrane Library, EBSCO, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP, with a search period spanning from the inception of the databases to January 2026. Cohort studies or case-control studies investigating the correlation between skin perfusion parameters and the prognosis of sepsis patients (primary outcomes: 28-day mortality, 14-day mortality, and in-hospital mortality) were included. Two researchers independently performed literature screening, data extraction, and assessment of the Newcastle-Ottawa Scale (NOS) bias risk. A meta-analysis was performed using RevMan 5.4.1 software. Results: This study included a total of 22 articles, encompassing 2,727 study subjects. The meta-analysis results demonstrated that: (1) Mottling Score (MS), was significantly associated with 28-day mortality (Odds Ratio OR=2.27, 95% Confidence Interval CI: 1.79, 2.87, P<0.001) and 14-day mortality (OR=1.96, 95% CI: 1.32, 2.91, P<0.001); (2) Prolonged Capillary Refill Time (CRT) duration was significantly associated with 28-day mortality (OR=3.29, 95% CI: 2.08, 5.21, P<0.001) and in-hospital mortality (OR=2.46, 95% CI: 1.18, 5.12, P<0.001); (3) Reduced Peripheral Perfusion Index (PPI) was significantly associated with 28-day mortality (OR=5.05, 95% CI: 3.65, 6.98, P<0.001) and in-hospital mortality (OR=4.56, 95% CI: 3.32, 6.26, P<0.001). Sensitivity analysis confirmed robust results with no significant publication bias. Conclusion: The MS, CRT, and PPI, as bedside and non-invasive skin perfusion parameters, demonstrate significant predictive value for mortality risk in sepsis patients. Integrating these indicators facilitates early clinical identification of high-risk patients, guiding risk stratification and resuscitation therapy. Future large-sample prospective studies are required to further standardize their assessment protocols and intervention thresholds. Plain Language SummaryThis systematic review and meta-analysis examined whether bedside skin perfusion indicators predict mortality in sepsis. Twenty-two cohort or case-control studies with 2,727 patients were analyzed. Higher Mottling Score (MS) was associated with increased 28-day mortality (OR=2.27, 95% CI:1.79–2.87) and 14-day mortality (OR=1.96, 95% CI:1.32–2.91). Prolonged Capillary Refill Time (CRT) predicted higher 28-day (OR=3.29, 95% CI:2.08–5.21) and in-hospital mortality (OR=2.46, 95% CI:1.18–5.12). Reduced Peripheral Perfusion Index (PPI) showed the strongest association with 28-day (OR=5.05, 95% CI:3.65–6.98) and in-hospital mortality (OR=4.56, 95% CI:3.32–6.26). These non-invasive measures may help identify high-risk sepsis patients early and guide resuscitation, but large prospective studies are still needed. Text is machine generated and may contain inaccuracies. FAQ
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».