Abstract
Objective:To investigate the association of maximum HR during the first day of intensive care unit (ICU) and mortality.Methods:Data of 850 patients over 45 years of age, who were hospitalized in ICU, was retrospectively analyzed. They were divided into two groups; Group-I, patients with maximum HR<100/min Group-II, patients with maximum HR≥100/min on first day. The groups were compared regarding age, sex, use of beta-blockers, use of inotropic and vasopressor drugs, hemodynamic parameters, anemia, mechanical ventilation, length of hospitalization (ICU and total), mortality (ICU and total), and CHARLSON & APACHE-II scores.Results:The mean age of patients was 63±12 years and 86% were after non-cardiac surgery. Maximum HR was 83±11 in Group-I and 115±14/min in Group-II (p=0.002). Group-II patients had more frequent vasopressor and inotropic drugs usage, (p<0.001), anemia, mechanical ventilation (p<0.005), higher CHARLSON & APACHE-II scores, stayed longer in ICU and hospital, and had higher ICU and hospital mortality compared to group-I (p<0.05). APACHE-II scores and maximum HR<100/min were independent variables predicting ICU mortality in multivariate logistic regression analysis whereas usage of beta-blockers was not.Conclusions:Our study showed that maximum HR less than100/minute during the first day of ICU is associated with decreased mortality in Intensive Care Unit.
Highlights
Heart rate (HR) depends on the patient’s mood, physical activities, ventilation type, body temperature, myocardial contractility and myocardial capacity.1,2 During critical illnesses, patients have an increased metabolic rate in all types of organ metabolism
Epidemiological studies have shown that elevated HR is an independent risk factor for mortality and morbidity in even healthy individuals with or without hypertension and in patients with CAD, myocardial infarction (MI), or congestive heart failure (CHF)
The results of our study demonstrate that maximum HR
Summary
Heart rate (HR) depends on the patient’s mood, physical activities, ventilation type, body temperature, myocardial contractility and myocardial capacity. During critical illnesses, patients have an increased metabolic rate in all types of organ metabolism. Heart rate (HR) depends on the patient’s mood, physical activities, ventilation type, body temperature, myocardial contractility and myocardial capacity.. Patients have an increased metabolic rate in all types of organ metabolism. Maximum HR has been shown to indicate severity of disease and increased short-term mortality in critically ill patients.. Cardiovascular diseases and other medical conditions have an increased risk of longterm mortality due to tachycardia, experienced among critically ill patients as a result of increased sympathetic activity, insufficient pain control or sedation, arrhythmias or pro-arrhythmogenic treatments.. Epidemiological studies have shown that elevated HR is an independent risk factor for mortality and morbidity in even healthy individuals with or without hypertension and in patients with CAD, myocardial infarction (MI), or congestive heart failure (CHF).. It is difficult to define a threshold value for HR because it must be individualized in the context of the patient’s overall hemodynamic status and any pre-existing comorbidities. Numerous large, epidemiological studies have shown that elevated HR is an independent risk factor for mortality and morbidity in even healthy individuals with or without hypertension and in patients with CAD, myocardial infarction (MI), or congestive heart failure (CHF). Several large placebo-controlled trials have demonstrated that drugs which reduce HR, including beta blockers, can reduce mortality and morbidity in patients with acute MI or CHF.
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