TEG Lysis Shutdown Represents Coagulopathy in Bleeding Trauma Patients
Bibliographic record
Abstract
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
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".