Cardiac uncoupling and heart rate variability stratify ICU patients by mortality: a study of 2088 trauma patients.
 |
Related Articles |
Cardiac uncoupling and heart rate variability stratify ICU patients by mortality: a study of 2088 trauma patients.
Ann Surg. 2006 Jun;243(6):804-12; discussion 812-4
Authors: Norris PR, Ozdas A, Cao H, Williams AE, Harrell FE, Jenkins JM, Morris JA
OBJECTIVE: We have previously shown that cardiac uncoupling (reduced heart rate variability) in the first 24 hours of trauma ICU stay is a robust predictor of mortality. We hypothesize that cardiac uncoupling over the entire ICU stay independently predicts mortality, reveals patterns of injury, and heralds complications. METHODS: A total of 2088 trauma ICU patients satisfied the inclusion criteria for this study. Cardiac uncoupling by outcome was compared using the Wilcoxon rank sum test. Risk of death from cardiac uncoupling and covariates (age, ISS, AIS Head Score, total transfusion requirements) was assessed using multivariate logistic regression models at each ICU day. Univariate logistic regression was used to assess risk of death from uncoupling irrespective of covariates at each ICU day. RESULTS: A total of 1325 (63.5%) patients displayed some degree of uncoupling over their ICU stay. The difference in uncoupling between survivors and nonsurvivors is both dramatic and consistent across the entire ICU stay, indicating that the presence of uncoupling is unrelated to the cause of death. However, the magnitude of uncoupling varies by day when data is stratified by cause of death. CONCLUSIONS: Cardiac uncoupling: 1) is an independent predictor of death throughout the ICU stay, 2) has a predictive window of 2 to 4 days, and 3) appears to increase in response to inflammation, infection, and multiple organ failure.
PMID: 16772784 [PubMed - in process]
Related posts:
- Differences in heart rate variability between Asian and Caucasian children living in the same Canadian community.
- Prognostic value of homocysteinemia in patients with congestive heart failure.
- Oral magnesium therapy, exercise heart rate, exercise tolerance, and myocardial function in coronary artery disease patients.
- Plasma concentrations of interleukin-6, organ failure, vasopressor support, and successful coronary revascularization in predicting 30-day mortality of patients with cardiogenic shock complicating acute myocardial infarction*
- Antioxidant vitamins supplementation and mortality: A randomized trial in head and neck cancer patients.