Key result
Minimum heart rate ≥59 bpm in TBI ICU admission linked to ~84% higher 1-month mortality.
Why the study?
The association between minimum heart rate within 24 hours of ICU admission and 1-month mortality in traumatic brain injury patients remains unclear.
Does a minimum heart rate ≥59 bpm within 24 hours of ICU admission predict increased 1-month mortality in critically ill patients with traumatic brain injury?
Cohort (n=2,267)
No
Does a minimum heart rate ≥59 bpm within 24 hours of ICU admission predict increased 1-month mortality in critically ill patients with traumatic brain injury?
A U-shaped association exists between 24-hour minimum heart rate and 1-month mortality in ICU patients with traumatic brain injury, with values ≥59 bpm independently predicting increased mortality, particularly in non-hypertensive individuals.
The association between minimum heart rate (MinHR) within 24 hours of ICU admission and 1-month mortality in traumatic brain injury (TBI) patients remains unclear. This retrospective cohort study analyzed 2267 TBI patients from the MIMIC-IV v3.1 database. Multivariable Cox regression, restricted cubic spline (RCS) analysis, and subgroup analyses evaluated relationships between 24-hour MinHR and mortality. The cohort (median age 67 [IQR 51-80] years; 62.6% female) had a median MinHR of 59 [52-68] bpm, with 248 deaths (10.94%). RCS analysis revealed a U-shaped association (P for nonlinear =0.001) with 59 bpm as the inflection point. MinHR ≥59 bpm independently predicted higher mortality after full adjustment (HR=1.84, 95%CI:1.31-2.60; P<0.001). This association was pronounced in non-hypertensive patients (HR=1.50, 95%CI:1.08-2.08; P=0.015). A U-shaped association exists between 24-hour MinHR and 1-month mortality in TBI patients, with 59 bpm as the critical threshold. MinHR ≥59 bpm independently predicts increased mortality. These findings support using 59 bpm as an alert threshold for early intervention.
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Han et al. (2025) conducted a cohort in Traumatic brain injury (n=2,267). Minimum heart rate ≥ 59 bpm vs. Minimum heart rate < 59 bpm was evaluated on 1-month mortality (HR 1.84, 95% CI 1.31-2.60, p=<0.001). A minimum heart rate of ≥ 59 bpm within 24 hours of ICU admission independently predicted an 84% higher risk of 1-month mortality in patients with traumatic brain injury (HR 1.84).
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