Key result
Higher heart rate at CRRT initiation is linked to ~1% higher 30-day mortality per bpm.
Why the study?
Is a higher heart rate at the time of continuous renal replacement therapy (CRRT) initiation associated with increased 30-day all-cause mortality in ICU patients with severe acute kidney injury?
Cohort (n=828)
No
Is a higher heart rate at the time of continuous renal replacement therapy (CRRT) initiation associated with increased 30-day all-cause mortality in ICU patients with severe acute kidney injury?
Elevated heart rate at the initiation of continuous renal replacement therapy is linearly and independently associated with higher 30-day mortality in critically ill patients with acute kidney injury, though it does not predict successful CRRT weaning.
Answers are grounded in this paper and cite their sources.
Elevated heart rate may aid risk stratification at CRRT initiation in severe AKI; leaves open whether it is a modifiable target.
BACKGROUND: Heart rate (HR) is an essential vital sign based on the finding that HR beyond its normal range is associated with several conditions or diseases, including high mortality in several clinical settings. Nevertheless, the clinical implications of HR remain unresolved in patients undergoing continuous renal replacement therapy (CRRT). METHODS: This retrospective cohort study included 828 patients who underwent CRRT due to acute kidney injury between 2010 and 2014. HR and other baseline parameters at the time of CRRT initiation were retrieved. The odds ratio (OR) of 30-day mortality was calculated using a multivariate logistic model. However, HR was not associated with the weaning rate from CRRT. CONCLUSION: High HR at the time of CRRT initiation is subsequently related with high mortality. These results can be a basis for a future predictive model of CRRT-related mortality.
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Lee et al. (2017) conducted a cohort in Severe acute kidney injury requiring continuous renal replacement therapy (CRRT) (n=828). Heart rate at the time of CRRT initiation (4th quartile or per 1 beat/min increase) vs. Lower heart rate at CRRT initiation (1st quartile) was evaluated on All-cause mortality within 30 days (OR 1.01, 95% CI 1.002-1.015, p=0.012). Higher heart rate at CRRT initiation was independently associated with increased 30-day mortality (adjusted OR 1.01 per 1 beat/min increase, 95% CI 1.002-1.015, P=0.012; 4th vs 1st quartile adjusted OR 2.22).
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