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
SN - 0022-5282
VL - 62
SP - 812
EP - 817
JO - Journal of Trauma - Injury, Infection and Critical Care
JF - Journal of Trauma - Injury, Infection and Critical Care
IS - 4
ER -