Prolonged Elevated Heart Rate and 90-Day Survival in Acutely Ill Patients: Data From the MIMIC-III Database.
Citation: Journal of Intensive Care Medicine. 34(8):622-629, 2019 Aug.PMID: 29402151Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Critical Illness/mo [Mortality] | *Tachycardia/mo [Mortality] | Acute Disease | Adult | Aged | Critical Care | Databases, Factual | Female | Follow-Up Studies | Humans | Intensive Care Units | Logistic Models | Male | Middle Aged | Monitoring, Physiologic | Multivariate Analysis | Prognosis | Tachycardia/di [Diagnosis] | Time FactorsYear: 2019Local holdings: Available in print through MWHC library: 1992 - 2001ISSN:- 0885-0666
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 29402151 | Available | 29402151 |
Available in print through MWHC library: 1992 - 2001
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.
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