The importance of microcirculation for adverse outcomes in the early phase of critical illnesses has been reported. Microcirculatory function is assessed using the perfusion index (PI), which represents the level of circulation through peripheral tissues. We investigated the correlation between PI and cardiovascular death to explore whether it can serve as a predictor of cardiovascular death.

This retrospective study included 2171 patients admitted to Matsushita Memorial Hospital in Osaka, Japan, for medical treatment. We measured PI for all patients. To examine the effects of PI on cardiovascular death, a Cox proportional hazard model was used. The median age and PI values were 72 years (range 63–79 years) and 2.7% (range 1.4–4.6%), respectively. During the 3927.7 person-years follow-up period, a total of 54 patients died due to cardiovascular disease. PI was positively correlated with BMI (P < 0.0001) and total cholesterol levels (P = 0.004). PI was negatively correlated with age (P < 0.0001), heart rate (P < 0.0001), and creatinine levels (P < 0.0001). Adjusted Cox regression analyses demonstrated that PI was associated with an increased hazard of cardiovascular death (hazard ratio 0.84; 95% CI; range 0.72–0.99). In addition, compared with patients with a high PI (> 3.7%), those with a low PI (≤ 2.0%) had a significantly increased risk of cardiovascular death. This low PI group had a hazard ratio of 3.49 (95% CI 1.73–7.82).

The PI is a valuable predictor for cardiovascular death in a clinical setting.