TY - JOUR
T1 - Heart rate variability as a predictor of death in burn patients
AU - Loguidice, Michael J.
AU - Schutt, Robert C.
AU - Horton, Jureta W.
AU - Minei, Joseph P.
AU - Keeley, Ellen C.
N1 - Funding Information:
Supported by the National Institutes of Health (HL097074) and the American Heart Association (13IRG14560018) to E.C.K.
PY - 2016
Y1 - 2016
N2 - Heart rate variability (HRV), a noninvasive technique used to quantify fluctuations in the interval between normal heart beats (NN), is a predictor of mortality in some patient groups. The aim of this study was to assess HRV in burn trauma patients as a predictor of mortality. The authors prospectively performed 24-hour Holter monitoring on burn patients and collected demographic information, burn injury details, and in-hospital clinical events. Analysis of HRV in the time and frequency domains was performed. A total of 40 burn patients with a mean age of 44 ± 15 years were enrolled. Mean %TBSA burn was 27 ± 22% for the overall population and was significantly higher in those who died compared with those who survived (55 ± 23% vs 19 ± 13%; P <.0001). There was a statistically significant inverse linear correlation between SD of NN intervals and %TBSA (r = -.337, R2 = 0.113, 95% CI = -0.587 to -0.028, two-tailed P =.034), as well as with ultra low frequency power and %TBSA burn (r = -0.351, R2 = 0.123, 95% CI = -0.152 to -0.009; P =.027). The receiver-operator characteristic showed the area under the curve for %TBSA as a predictor of death was 0.82 (P <.001), for SDANN was 0.94 (P <.0001), and for ultra low frequency power was 0.96 (P <.0001). Deranged HRV in the early postburn period is a strong predictor of death.
AB - Heart rate variability (HRV), a noninvasive technique used to quantify fluctuations in the interval between normal heart beats (NN), is a predictor of mortality in some patient groups. The aim of this study was to assess HRV in burn trauma patients as a predictor of mortality. The authors prospectively performed 24-hour Holter monitoring on burn patients and collected demographic information, burn injury details, and in-hospital clinical events. Analysis of HRV in the time and frequency domains was performed. A total of 40 burn patients with a mean age of 44 ± 15 years were enrolled. Mean %TBSA burn was 27 ± 22% for the overall population and was significantly higher in those who died compared with those who survived (55 ± 23% vs 19 ± 13%; P <.0001). There was a statistically significant inverse linear correlation between SD of NN intervals and %TBSA (r = -.337, R2 = 0.113, 95% CI = -0.587 to -0.028, two-tailed P =.034), as well as with ultra low frequency power and %TBSA burn (r = -0.351, R2 = 0.123, 95% CI = -0.152 to -0.009; P =.027). The receiver-operator characteristic showed the area under the curve for %TBSA as a predictor of death was 0.82 (P <.001), for SDANN was 0.94 (P <.0001), and for ultra low frequency power was 0.96 (P <.0001). Deranged HRV in the early postburn period is a strong predictor of death.
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U2 - 10.1097/BCR.0000000000000260
DO - 10.1097/BCR.0000000000000260
M3 - Article
C2 - 26061155
AN - SCOPUS:84964989567
SN - 1559-047X
VL - 37
SP - e227-e233
JO - Journal of Burn Care and Research
JF - Journal of Burn Care and Research
IS - 3
ER -