The role of peripheral perfusion index in differential diagnosis of cardiac and pulmonary-origin dyspnea in emergency service

Abstract

Introduction: Pulmonary and cardiac disorders are diagnosed in most patients presenting to the emergency department with dyspnea. Discrimination of pulmonary and cardiac pathologies from each other and early intervention have vital importance. Various methods have been used for assessment of peripheral perfusion, and the peripheral perfusion index) has gained popularity in recent years. This study aimed to investigate the contribution of peripheral perfusion index to the evaluation process in patients presenting with the complaint of dyspnea and diagnosed with either a pulmonary or cardiac pathology. Materials and Methods: We retrospectively reviewed the charts of patients who presented to emergency department with dyspnea between 1 July 2018 and 1 July 2019. Patients in whom the cause of dsypnea was determined to be a cardiac or pulmonary pathology were included in the study. The age, gender, peripheral perfusion index value at admission, the diagnosis, and the hospitalization status were recorded. Results: One hundred and ninety patients consisting of 106 (55.8%) males and 84 (44.2%) females were included in our study. While a pulmonary pathology was determined in 141 (74.2%) patients and a cardiac pathology in 49 (25.8%) patients, 72 (37.9%) patients were decided to be hospitalized. No difference was determined between patients with pulmonary and cardiac pathologies regarding peripheral perfusion index. When the patients were compared regarding hospitalization status and discharge from the emergency department, no significant difference was found to be present between the groups. Conclusion: Since peripheral perfusion index is a noninvasive, easy-to-perform, rapid, and reproducible test, it has been promising as a prognostic and diagnostic parameter. However, it has been realized that PPI was unsuccessful in the evaluation of patients with dyspnea, in the differential diagnosis of cardiac and pulmonary pathologies and prediction of hospitalization status in the emergency department.