Peripheral perfusion index as a predictor of severe shock in trauma patients: a prospective observational…

ObservationalEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society· Aug 2026

Peripheral perfusion index as a predictor of severe shock in trauma patients: a prospective observational study.

Haarini Sundar, Vijayan Purushothaman, Shona Rachel Mathuram … Joses Dany James

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Emergency MedicineObservationalDiagnosisQ1IF 2.5

Low peripheral perfusion index independently predicted severe hemorrhagic shock in trauma patients

Peripheral perfusion index as a predictor of severe shock in trauma patients: a prospective observational study.

Haarini Sundar … Joses Dany James

European journal of trauma and emergency surgery · Aug 2026 · Q1 in Emergency Medicine

Background

Early recognition of haemorrhagic shock is critical in trauma care, particularly in low- and middle-income countries where delayed referral is common.

Purpose

This study evaluated the ability of Perfusion Index to identify severe haemorrhagic shock in trauma patients and compared its performance with the Shock Index (Shock Index) and Modified Shock Index (mSI).

Methods

This prospective, single-centre study was conducted at a Level 1 trauma centre between January and May 2024.

n = 120 patients

Results

lower fingertip blood flow more than triples the odds of severe shock

OR 3.62 (95% CI 1.41 to 9.29)

CI excludes the null - significant

More results

Severe shock was present in 35 patients (29.2%).

1.33 [0.71-2.16], p = 0.008).

Perfusion Index demonstrated fair discrimination for severe shock (AUC 0.76; sensitivity 72%, specificity 66%) and 24-hour mortality (AUC 0.71).

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Conclusion · 1 of 2

Perfusion Index demonstrated moderate discriminatory ability and may serve as a useful non-invasive adjunct for identifying severe haemorrhagic shock.

Conclusion · 2 of 2

Its continuous, operator-independent measurement supports a potential role in early triage and resuscitation, particularly in resource-limited settings.

Peripheral perfusion index as a predictor of severe shock in trauma patients: a prospective observational study.

Peripheral perfusion index as a predictor of severe shock in trauma patients: a prospective observational study.

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