Capillary refill time as a predictor of mortality in cancer patients with sepsis-associated circulatory dysfunction: A prospective cohort study

García-Aguilera M.F.; Hernández G.; Pozo M.; Basantes E.; Unigarro L.; Llerena P.; Montenegro C.; Brito D.; Jiménez J.; Aldean G.; Alexander-León H.; Yu Liu Y.; Manterola C.; Figueroa V.; García-Méndez N.; Otzen T. · Acta Colombiana de Cuidado Intensivo (2026) · DOI: 10.1016/j.acci.2026.100618

Resumen

Introduction: Capillary refill time (CRT) is a simple clinical marker of peripheral perfusion that has been associated with adverse outcomes in critically ill patients. However, its prognostic value in cancer patients with sepsis-associated circulatory dysfunction has not been widely studied. Objective: To evaluate capillary refill time as a predictor of mortality in cancer patients cancer patients with sepsis-associated circulatory dysfunction. Methods: A prospective multicenter cohort study was conducted with 187 cancer patients with circulatory dysfunction admitted to two intensive care units in Quito, Ecuador, between June 2023 and June 2024. Capillary refill time and other perfusion parameters were measured at baseline and at 2, 6, and 24 h after resuscitation. Survival analysis and receiver operating characteristic curves were used to assess the discriminative ability of perfusion variables. Results: Capillary refill time was significantly higher in non-survivors across all measurements (p < 0.001). The capillary refill time measured at 6 h presented the highest discriminative capacity, with an area under the curve of 0.750 (95% CI: 0.676–0.825). In multivariable Cox regression, capillary refill time ≥3.0 s at 6 h was independently associated with mortality (HR = 2.15; 95% CI: 1.02–4.52; p = 0.044). Conclusions: Capillary refill time, particularly at 6 h, is a useful predictor of mortality in cancer patients with sepsis-associated circulatory dysfunction. Its simplicity and low cost position it as a promising tool for clinical management in the intensive care unit.

Instituciones: Universidad Peruana Cayetano Heredia