Prolonged Elevated Heart Rate and 90-Day Survival in Acutely Ill Patients: Data From the MIMIC-III Database. 

 -  2019 
<br/><br/>Available in print through MWHC library: 1992 - 2001 
<br/><br/> CONCLUSION: We found a significant association of peHR with decreased survival in a large and heterogenous cohort of ICU patients.  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.  PURPOSE: We sought to evaluate the association of prolonged elevated heart rate (peHR) with survival in acutely ill patients.  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. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0885-0666 
<br/><br/><label>Standard No.: </label>10.1177/0885066618756828 [doi] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Critical Illness/mo [Mortality]<br/>*Tachycardia/mo [Mortality]<br/>Acute Disease<br/>Adult<br/>Aged<br/>Critical Care<br/>Databases, Factual<br/>Female<br/>Follow-Up Studies<br/>Humans<br/>Intensive Care Units<br/>Logistic Models<br/>Male<br/>Middle Aged<br/>Monitoring, Physiologic<br/>Multivariate Analysis<br/>Prognosis<br/>Tachycardia/di [Diagnosis]<br/>Time Factors
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Health Research Institute<br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Medicine/Internal Medicine
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article