Heart rate: Is it truly a vital sign?

Karen J. Brasel, Clare Guse, Larry M. Gentilello, Ram Nirula

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

BACKGROUND: Tachycardia, often defined as heart rate >100 bpm, has been utilized as a physical sign of hypovolemic shock among the injured for decades without evidence to support its use as a predictor of injury or significant hypovolemia. We sought to determine whether admission heart rate is a valid predictor of hemodynamically significant injuries. METHODS: Trauma registry data from 1998 to 2004 were analyzed with logistic regression to determine whether heart rate was associated with need for emergent intervention for bleeding (laparotomy, thoracotomy, or angiography), need for packed red blood cell (pRBC) transfusion in the first 24 hours, or severe injury (ISS >25) after blunt or penetrating trauma. RESULTS: Records of 10,825 patients were analyzed. Overall, heart rate was neither sensitive nor specific in determining the need for emergent intervention, pRBCs in the first 24 hours or severe injury. This was not altered by the presence of hypotension (systolic blood pressure <90 mm Hg) or age in the blunt cohort. CONCLUSIONS: Heart rate alone is not sufficient to determine the need for emergent interventions for hemorrhage. Although tachycardia may still indicate need for emergent intervention in the trauma patient, its absence should not allay such concern.

Original languageEnglish (US)
Pages (from-to)812-817
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume62
Issue number4
DOIs
StatePublished - Apr 2007

Fingerprint

Vital Signs
Heart Rate
Wounds and Injuries
Tachycardia
Hemorrhage
Blood Pressure
Erythrocyte Transfusion
Hypovolemia
Thoracotomy
Hypotension
Laparotomy
Registries
Shock
Angiography
Logistic Models

Keywords

  • Hypovolemia
  • Shock
  • Tachycardia
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this

Heart rate : Is it truly a vital sign? / Brasel, Karen J.; Guse, Clare; Gentilello, Larry M.; Nirula, Ram.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 62, No. 4, 04.2007, p. 812-817.

Research output: Contribution to journalArticle

Brasel, Karen J. ; Guse, Clare ; Gentilello, Larry M. ; Nirula, Ram. / Heart rate : Is it truly a vital sign?. In: Journal of Trauma - Injury, Infection and Critical Care. 2007 ; Vol. 62, No. 4. pp. 812-817.
@article{c85b1848266347179e3b6e2ecb933e56,
title = "Heart rate: Is it truly a vital sign?",
abstract = "BACKGROUND: Tachycardia, often defined as heart rate >100 bpm, has been utilized as a physical sign of hypovolemic shock among the injured for decades without evidence to support its use as a predictor of injury or significant hypovolemia. We sought to determine whether admission heart rate is a valid predictor of hemodynamically significant injuries. METHODS: Trauma registry data from 1998 to 2004 were analyzed with logistic regression to determine whether heart rate was associated with need for emergent intervention for bleeding (laparotomy, thoracotomy, or angiography), need for packed red blood cell (pRBC) transfusion in the first 24 hours, or severe injury (ISS >25) after blunt or penetrating trauma. RESULTS: Records of 10,825 patients were analyzed. Overall, heart rate was neither sensitive nor specific in determining the need for emergent intervention, pRBCs in the first 24 hours or severe injury. This was not altered by the presence of hypotension (systolic blood pressure <90 mm Hg) or age in the blunt cohort. CONCLUSIONS: Heart rate alone is not sufficient to determine the need for emergent interventions for hemorrhage. Although tachycardia may still indicate need for emergent intervention in the trauma patient, its absence should not allay such concern.",
keywords = "Hypovolemia, Shock, Tachycardia, Trauma",
author = "Brasel, {Karen J.} and Clare Guse and Gentilello, {Larry M.} and Ram Nirula",
year = "2007",
month = "4",
doi = "10.1097/TA.0b013e31803245a1",
language = "English (US)",
volume = "62",
pages = "812--817",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Heart rate

T2 - Is it truly a vital sign?

AU - Brasel, Karen J.

AU - Guse, Clare

AU - Gentilello, Larry M.

AU - Nirula, Ram

PY - 2007/4

Y1 - 2007/4

N2 - BACKGROUND: Tachycardia, often defined as heart rate >100 bpm, has been utilized as a physical sign of hypovolemic shock among the injured for decades without evidence to support its use as a predictor of injury or significant hypovolemia. We sought to determine whether admission heart rate is a valid predictor of hemodynamically significant injuries. METHODS: Trauma registry data from 1998 to 2004 were analyzed with logistic regression to determine whether heart rate was associated with need for emergent intervention for bleeding (laparotomy, thoracotomy, or angiography), need for packed red blood cell (pRBC) transfusion in the first 24 hours, or severe injury (ISS >25) after blunt or penetrating trauma. RESULTS: Records of 10,825 patients were analyzed. Overall, heart rate was neither sensitive nor specific in determining the need for emergent intervention, pRBCs in the first 24 hours or severe injury. This was not altered by the presence of hypotension (systolic blood pressure <90 mm Hg) or age in the blunt cohort. CONCLUSIONS: Heart rate alone is not sufficient to determine the need for emergent interventions for hemorrhage. Although tachycardia may still indicate need for emergent intervention in the trauma patient, its absence should not allay such concern.

AB - BACKGROUND: Tachycardia, often defined as heart rate >100 bpm, has been utilized as a physical sign of hypovolemic shock among the injured for decades without evidence to support its use as a predictor of injury or significant hypovolemia. We sought to determine whether admission heart rate is a valid predictor of hemodynamically significant injuries. METHODS: Trauma registry data from 1998 to 2004 were analyzed with logistic regression to determine whether heart rate was associated with need for emergent intervention for bleeding (laparotomy, thoracotomy, or angiography), need for packed red blood cell (pRBC) transfusion in the first 24 hours, or severe injury (ISS >25) after blunt or penetrating trauma. RESULTS: Records of 10,825 patients were analyzed. Overall, heart rate was neither sensitive nor specific in determining the need for emergent intervention, pRBCs in the first 24 hours or severe injury. This was not altered by the presence of hypotension (systolic blood pressure <90 mm Hg) or age in the blunt cohort. CONCLUSIONS: Heart rate alone is not sufficient to determine the need for emergent interventions for hemorrhage. Although tachycardia may still indicate need for emergent intervention in the trauma patient, its absence should not allay such concern.

KW - Hypovolemia

KW - Shock

KW - Tachycardia

KW - Trauma

UR - http://www.scopus.com/inward/record.url?scp=34247203174&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34247203174&partnerID=8YFLogxK

U2 - 10.1097/TA.0b013e31803245a1

DO - 10.1097/TA.0b013e31803245a1

M3 - Article

C2 - 17426534

AN - SCOPUS:34247203174

VL - 62

SP - 812

EP - 817

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 4

ER -