Clinical Predictors of Capillary Refill Time and Their Association With Triage Categories (CRT_TriageER)

June 26, 2025 updated by: Zeynep Sofuoglu, Izmir Democracy University

Clinical Predictors of Capillary Refill Time and Their Association With Triage Categories From the Emergency Department Perspective: A Cross-Sectional Study

This observational study aims to determine the correlation between capillary refill time (CRT) and vital parameters in patients presenting to the emergency department.

It explores whether CRT is associated with triage categories and vital signs in non-traumatic patients, including oxygen saturation (SpO₂), heart rate, systolic and diastolic blood pressure, body temperature, forearm temperature, and respiratory rate.

Patients admitted to the emergency department of a training and research hospital were assigned triage codes (green, yellow, red). Their CRT was measured three times, and vital signs were recorded accordingly.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

In the initial evaluation, patients admitted to the emergency department were assigned a triage color code, categorized as green, yellow, or red. In the color-coding system employed, green was designated as low urgency, yellow as medium urgency, and red as urgent. The allocation of triage codes is the responsibility of nurses who have undergone the requisite training. Following the completion of the assigned task, the emergency specialist proceeded to meticulously record a series of physiological parameters. These parameters included the CRT (in seconds), the percentage of oxygen saturation in the blood (SpO2%), the heart rate (in minutes), the systolic and diastolic blood pressure (in mmHg), the body temperature (in degrees Celsius), the forearm temperature measured at the CRT, and the respiratory rate (in minutes). CRT was evaluated three times for each patient, and the mean of these values was recorded as the CRT.

Study Type

Observational

Enrollment (Actual)

313

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Izmir, Turkey
        • Buca Training and Research Hospital, Emergency Deaprtment

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The study population consists of non-trauma patients who applied to the emergency department of Buca Research and Training Hospital.

Description

Inclusion Criteria:

  • individuals over the age of 18 years who consented to participate in the study

Exclusion Criteria:

  • The presence of pregnancy
  • Multiple traumas resulting in hypovolemia
  • The absence of fingers or limbs
  • The utilization of vasopressors or inotropic pharmacological agents
  • The existence of peripheral arterial disease
  • The presence of nail polish or fake nails

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Non-traumatic patients admitted to the emergency department of Izmir Democracy University Buca Seyfi
Other: No clinical intervention (observational study only)
This is an observational study. No experimental or clinical intervention was applied. Only non-invasive data collection such as capillary refill time and vital sign measurements was performed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Triage Code Assignment
Time Frame: Baseline [within 30 minutes of initial Emergency department admission triage assessment]

Triage code assignment will be completed within the first 30 minutes of the patient's initial presentation to the emergency department (ED). Patients will be categorized into green, yellow, or red triage groups based on standard emergency triage protocols upon admission.

Following this, the patient will be transferred to the designated emergency care room (ER) based on the assigned triage code and further clinical evaluation and treatment.

Initially, the triage nurse will assess the patient and assign the triage code. Following this, the patient will be transferred to the designated emergency care room (ER), where a specialist emergency physician will perform further clinical evaluation and treatment.
Baseline [within 30 minutes of initial Emergency department admission triage assessment]
Capillary Refill Time (CRT) in Seconds
Time Frame: Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room
CRT will be measured in seconds using a stopwatch after pressing the fingertip. The measurement will be repeated three times and average was calculated.Triage code assignment will be completed within the first 30 minutes of the patient's initial presentation to the emergency department (ED). Following this, the patient will be transferred to the designated emergency care room (ER) based on the assigned triage code, and all vital parameters (e.g., capillary refill time, heart rate, blood pressure) will be measured within 10 minutes of entering the emergency care area.
Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room
Heart Rate
Time Frame: The patient is then assessed by the emergency physician within 10 minutes of being transferred to the ER triage code section. (Single measurement )
Heart rate will be recorded using standard clinical devices. Unit: Beats per minute Measurement technique:: Measured using clinical monitor.. Upon the patient's initial presentation to the emergency department (ED), triage code assignment will be completed within the first 30 minutes. Based on the assigned code, the patient will be directed to the appropriate emergency care room (ER). Heart rate measurements will be taken within 10 minutes of the patient's arrival in the emergency care room.
The patient is then assessed by the emergency physician within 10 minutes of being transferred to the ER triage code section. (Single measurement )
Systolic Blood Pressure
Time Frame: Single simultaneous measurement (systolic and diastolic) by the emergency physician within 10 minutes of arrival in the emergency care room (ER).

systolic blood pressure will be recorded using standard clinical devices. Unit: mmHg Measurement technique: Measured using clinical monitor.

Upon the patient's initial presentation to the emergency department (ED), triage code assignment will be completed within the first 30 minutes. Based on the assigned triage code, the patient will be directed to the appropriate emergency care room (ER).

Systolic blood pressure will be measured once, within 10 minutes of the patient's arrival in the emergency care room.

Systolic and diastolic blood pressure will be measured simultaneously in a single session within 10 minutes of the patient's arrival in the emergency care room.
Single simultaneous measurement (systolic and diastolic) by the emergency physician within 10 minutes of arrival in the emergency care room (ER).
Diastolic Blood Pressure
Time Frame: Single simultaneous measurement (systolic and diastolic) by the emergency physician within 10 minutes of arrival in the emergency care room (ER).

diastolic blood pressure will be recorded using standard clinical devices. Unit: mmHg Measurement technique: Measured using clinical monitor. Upon the patient's initial presentation to the emergency department (ED), triage code assignment will be completed within 30 minutes. Based on the assigned triage code, the patient will be transferred to the appropriate emergency care room (ER).

Diastolic and systolic blood pressure will be measured simultaneously in a single session within 10 minutes of the patient's arrival in the emergency care room.
Single simultaneous measurement (systolic and diastolic) by the emergency physician within 10 minutes of arrival in the emergency care room (ER).
SpO2 (Oxygen Saturation)
Time Frame: Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room
SpO2 will be recorded using standard clinical devices. Unit: Percent (%) Measurement technique: Measured using pulse oximetry. Oxygen saturation (SpO₂), along with other vital signs (blood pressure, heart rate), will be measured in a single session within 10 minutes of the patient's arrival in the emergency care room.
Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room
Respiratory Rate
Time Frame: Following the patient's admission to the ER, the triage nurse determins the patient's triage code. The patient is then assessed by the emergency physician within 10 minutes of being transferred to the ER triage code section. (single timepoint)
respiratory rate will be recorded using standard clinical devices. Unit: Breaths per minute Measurement technique: Measured using observation and counting.
Following the patient's admission to the ER, the triage nurse determins the patient's triage code. The patient is then assessed by the emergency physician within 10 minutes of being transferred to the ER triage code section. (single timepoint)
Forearm Temperature
Time Frame: Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room (ER).
Forearm temperature will be recorded using standard clinical devices. Unit: Degrees Celsius Measurement technique: Measured using infrared thermometer.
Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room (ER).
Body Temperature
Time Frame: Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room (ER).

Body temperature will be recorded using standard clinical devices. Unit: Degrees Celsius. Body temperature was measured with a Yobekan model KV-11 infrared measuring device.

Measurement technique: Measured using infrared thermometer. All vital signs, including body temperature, were assessed sequentially by the same emergency physician within 10 minutes after the patient was transferred to the emergency care room (ER).
Single measurement by the emergency physician within 10 minutes of the patient's arrival in the emergency care room (ER).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Correlation Between Capillary Refill Time and Age
Time Frame: During the study period through data collection and data entry, expected to be completed within an average of 3 months.

Pearson correlation analysis will be used to assess the correlation between capillary refill time (measured in seconds using a stopwatch and averaged from three measurements) and patient age (recorded in years from patient records).

Unit of Measure:

Capillary Refill Time (Mean): seconds Age: years

Measurement Tool:

CRT measured with a stopwatch by a trained emergency specialist Age extracted from patient record All CRT measurements will be taken within 10 minutes of the patient's arrival in the emergency care room by the same emergency physician, as part of the initial clinical evaluation.
During the study period through data collection and data entry, expected to be completed within an average of 3 months.
Association Between Prolonged CRT (>2s) and Triage Category
Time Frame: During the study period through data collection and data entry, expected to be completed within an average of 3 months.

Logistic regression will be used to assess the association between prolonged CRT (defined as >2 seconds, averaged from three measurements using a stopwatch) and triage category (Green, Yellow, Red) assigned at emergency department admission.

Unit of Measure:

CRT: seconds Triage: categorical (Green, Yellow, Red)

Measurement Tool:

CRT measured with a stopwatch (three repetitions, averaged) Triage assignment performed by certified triage nurse based on hospital protocol All CRT measurements were performed within 10 minutes of the patient's arrival in the emergency care room by the same emergency physician, as part of the initial vital sign assessment.
During the study period through data collection and data entry, expected to be completed within an average of 3 months.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Izmir Democracy University

Investigators

  • Study Director: Aysel Başer, Assoc.Prof., Izmir Democracy University, Medical Faculty

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 1, 2024

Primary Completion (Actual)

September 30, 2024

Study Completion (Actual)

September 30, 2024

Study Registration Dates

First Submitted

May 21, 2025

First Submitted That Met QC Criteria

June 26, 2025

First Posted (Estimated)

July 8, 2025

Study Record Updates

Last Update Posted (Estimated)

July 8, 2025

Last Update Submitted That Met QC Criteria

June 26, 2025

Last Verified

June 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IzmirDemocracy

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Individual participant data (IPD) will be shared with other researchers upon reasonable request, provided they submit a clear and justified explanation of their research purpose.

IPD Sharing Time Frame

IPD and supporting document can be available between 01 September 2025 - 31 August 2028

IPD Sharing Access Criteria

Access to the IPD will be granted to qualified researchers affiliated with academic or research institutions, upon submitting a research proposal that is approved by an independent ethics committee

IPD Sharing Supporting Information Type

  • ICF
  • ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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