MedStar Authors catalog › Details for: Prolonged Elevated Heart Rate and 90-Day Survival in Acutely Ill Patients: Data From the MIMIC-III Database.
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Prolonged Elevated Heart Rate and 90-Day Survival in Acutely Ill Patients: Data From the MIMIC-III Database.

by Sandfort, Veit; Vargas, Jose D.
Citation: Journal of Intensive Care Medicine. :885066618756828, 2018 Jan 01.Journal: Journal of intensive care medicine.Published: 2018ISSN: 0885-0666.Full author list: Sandfort V; Johnson AEW; Kunz LM; Vargas JD; Rosing DR.UI/PMID: 29402151.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Washington Hospital Center | MedStar Health Research InstituteDepartment(s): Medicine/Internal MedicineActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1177/0885066618756828 (Click here) Abbreviated citation: J Intensive Care Med. :885066618756828, 2018 Jan 01.Local Holdings: Available in print through MWHC library: 1992 - 2001.Abstract: PURPOSE: We sought to evaluate the association of prolonged elevated heart rate (peHR) with survival in acutely ill patients.Abstract: METHODS: We used a large observational intensive care unit (ICU) database (Multiparameter Intelligent Monitoring in Intensive Care III [MIMIC-III]), where frequent heart rate measurements were available. The peHR was defined as a heart rate >100 beats/min in 11 of 12 consecutive hours. The outcome was survival status at 90 days. We collected heart rates, disease severity (simplified acute physiology scores [SAPS II]), comorbidities (Charlson scores), and International Classification of Diseases (ICD) diagnosis information in 31 513 patients from the MIMIC-III ICU database. Propensity score (PS) methods followed by inverse probability weighting based on the PS was used to balance the 2 groups (the presence/absence of peHR). Multivariable weighted logistic regression was used to assess for association of peHR with the outcome survival at 90 days adjusting for additional covariates.Abstract: RESULTS: The mean age was 64 years, and the most frequent main disease category was circulatory disease (41%). The mean SAPS II score was 35, and the mean Charlson comorbidity score was 2.3. Overall survival of the cohort at 90 days was 82%. Adjusted logistic regression showed a significantly increased risk of death within 90 days in patients with an episode of peHR ( P < .001; odds ratio for death 1.79; confidence interval, 1.69-1.88). This finding was independent of median heart rate.Abstract: CONCLUSION: We found a significant association of peHR with decreased survival in a large and heterogenous cohort of ICU patients.

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