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January 4, 2022Frontiers in PediatricsOpen Access

Autonomic Nervous System Dysfunction Is Associated With Re-hospitalization in Pediatric Septic Shock Survivors

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Why the study?

Re-hospitalization after sepsis can impair quality of life, and predictors of re-hospitalization are needed to identify survivors who might benefit from targeted interventions.

Is low heart rate variability associated with an increased risk of re-hospitalization in pediatric septic shock survivors?

Population

463 pediatric septic shock survivors admitted to the PICU at a single institution

Comparison

Heart rate variability measures (last HRVi, lowest HRVi, delta HRVi) vs re-hospitalization status

Design

Single-center retrospective observational cohort study

Follow-up

1 year

Authors

CBColleen M. BadkeNorthwestern UniversityLSLindsey R. SwigartLurie Children's HospitalMCMichael S. CarrollLurie Children's Hospital

Discussion

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Member takes

Implication

May flag re-hospitalization risk in pediatric septic shock survivors; hypothesis-generating and should not yet change practice.

Structured PICO

Is low heart rate variability associated with an increased risk of re-hospitalization in pediatric septic shock survivors?

P
Population
463 pediatric septic shock survivors admitted to the pediatric intensive care unit at a single institution between 6/2012 and 10/2020, who had continuous heart rate data available.
I
Intervention
Low heart rate variability (HRV) measured by age-normalized z-scores of integer HRV (HRVi) and smaller recovery in delta HRVi
C
Comparator
Higher heart rate variability (HRV) and larger recovery in delta HRVi
O
Outcome
Re-hospitalization within 1 year of discharge, including both emergency department encounters and hospital readmissionhard clinical

In pediatric septic shock survivors, a smaller recovery in heart rate variability during the index admission is significantly associated with an increased risk of re-hospitalization within 1 year.

Cite This Study

Badke et al. (2022) studied this question.

synapsesocial.com/papers/6a89140c6ef699e80f1ff16ehttps://doi.org/10.3389/fped.2021.745844
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Decomplexification in critical illness and injury: Relationship between heart rate variability, severity of illness, and outcome1998 · 186 citations
  2. 2Autonomic dysfunction predicts mortality in patients with multiple organ dysfunction syndrome of different age groups*2005 · 291 citations
  3. 3Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation2014 · 1,794 citations
  4. 4The Epidemiology of Severe Sepsis in Children in the United States2003 · 879 citations
  5. 5The Pediatric Risk of Mortality Score2015 · 273 citations