Both high (≥35 bpm) and low (<25 bpm) 24-hour heart rate fluctuations increased 28-day mortality in ICU patients compared to moderate fluctuations (HR 1.210 and 1.130, respectively).
Does high or low heart rate fluctuation predict mortality in critically ill ICU patients?
Both high (≥35 bpm) and low (<25 bpm) initial 24-hour heart rate fluctuations are associated with increased 28-day and 1-year mortality in critically ill ICU patients compared to a fluctuation of 25-34 bpm.
Absolute Event Rate: 0% vs 0%
BACKGROUND: To evaluate the association between heart rate (HR) fluctuation and mortality in critically ill patients in the intensive care unit (ICU). METHODS: A total of 27,814 patients were enrolled from the Medical Information Mart for Intensive Care database and were divided into 3 groups: low HR fluctuation <25 beats per minute (bpm), control (25-34 bpm), and high HR fluctuation (≥35 bpm), based on the initial 24-hour HR fluctuation (calculated as the maximum HR minus minimum HR). Multivariate Cox regression and restricted cubic spline models were used. RESULTS: Compared to the control group, higher risk of 28-day and 1-year mortality remained significant in an adjusted model, with hazard ratios of 1.210 95% confidence interval (CI), 1.103-1.327 and 1.150 (95% CI, 1.078-1.227), respectively, in the high HR fluctuation group, as well as hazard ratios of 1.130 (95% CI, 1.035-1.232) and 1.087 (95% CI, 1.022-1.157), respectively, in the low HR fluctuation group. Restricted cubic splines showed a U-type curve, with the lowest risk of mortality at an HR fluctuation of 30 bpm. CONCLUSIONS: This retrospective cohort study revealed that both high and low HR fluctuation correlated with increased mortality in critically ill ICU patients, providing new insights for optimizing HR control strategies.
Guo et al. (Mon,) reported a other. Both high (≥35 bpm) and low (<25 bpm) 24-hour heart rate fluctuations increased 28-day mortality in ICU patients compared to moderate fluctuations (HR 1.210 and 1.130, respectively).