Heart rate fluctuation predicts mortality in critically ill patients in the intensive care unit: a retrospective cohort study

Figures

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  Figure 1. Flow chart of patient selection from the MIMIC-III database. ICU, intensive care unit; HR, heart rate; bpm, beats per minute; MIMIC, Medical Information Mart for Intensive Care.

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  Figure 2. Survival curves for (A) 28-day mortality and (B) 1-year mortality among different HR fluctuation groups. Participants were divided into 3 groups based on initial 24-hour HR fluctuation: low HR fluctuation (<25 bpm), control (25–34 bpm), and high HR fluctuation (≥35 bpm). HR, heart rate; bpm, beats per minute.

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  Figure 3. Association between HR fluctuation and adjusted hazard ratios for (A) 28-day mortality and (B) 1-year mortality. These analyses used a model with restricted cubic splines and were adjusted for age, male sex, weight, SAPS score, SOFA score, mean HR, ventilation, vasopressors, sedatives, arrhythmias, CHF, hypertension, diabetes, renal failure, and liver disease. The reference (hazard ratio =1, horizontal dotted line) is an HR of 30 bpm (vertical dotted line). HR, heart rate; CI, confidence interval; bpm, beats per minute; SAPS, simplified acute physiology score; SOFA, sequential organ failure assessment; CHF, congestive heart failure.

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  Figure 4. The association between HR fluctuation and 28-day mortality in subgroups. These analyses used multivariate Cox regression modeling and were adjusted for age, male sex, weight, SAPS score, SOFA score, mean HR, ventilation, vasopressors, sedatives, arrhythmias, CHF, hypertension, diabetes, renal failure, and liver disease. The reference group was the control group. HR, heart rate; CI, confidence interval; bpm, beats per minute; SAPS, simplified acute physiology score; SOFA, sequential organ failure assessment; CHF, congestive heart failure; AKI, acute kidney injury.

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  Figure 5. The association between HR fluctuation and 1-year mortality in subgroups. These analyses used multivariate Cox regression modeling and were adjusted for age, male sex, weight, SAPS score, SOFA score, mean HR, ventilation, vasopressors, sedatives, arrhythmias, CHF, hypertension, diabetes, renal failure, and liver disease. The reference group was the control group. HR, heart rate; CI, confidence interval; bpm, beats per minute; SAPS, simplified acute physiology score; SOFA, sequential organ failure assessment; CHF, congestive heart failure; AKI, acute kidney injury.