TY - JOUR
T1 - Early alterations in heart rate are associated with poor outcome in patients with intracerebral hemorrhage
AU - Rass, Verena
AU - Lindner, Anna
AU - Ianosi, Bogdan-Andrei
AU - Schiefecker, Alois Josef
AU - Loveys, Sebastian
AU - Kofler, Mario
AU - Rass, Sofia
AU - Pfausler, Bettina
AU - Beer, Ronny
AU - Schmutzhard, Erich
AU - Helbok, Raimund
N1 - Copyright © 2020. Published by Elsevier Inc.
PY - 2021/2
Y1 - 2021/2
N2 - PURPOSE: Cardiac complications are common after spontaneous intracerebral hemorrhage (ICH). In this study we intended to investigate factors associated with higher alterations in heart rate and their impact on outcome.METHODS: Eighty-eight ICH patients were included. A simplified approach to calculate heart rate variability (HRSD) in analogy to systolic blood pressure variability (SBPSD) with daily standard deviations of HR in the acute (first 24 h) and subacute phase (day1-day7) was used. Using multivariable regression, factors associated with higher HRSD and the association between higher HRSD and poor 3-month outcome (modified Rankin Scale > 3) were analyzed. All models were adjusted for age, atrial fibrillation, mechanical ventilation, vasopressor administration, and mean HR.RESULTS: Patients were 71 (IQR = 60-79) years old and presented with an admission ICH-Score of 2 (IQR = 1-3). In multivariable analysis, intraventricular hemorrhage (adjOR = 8.66, 95%-CI = 1.89-39.60, p = 0.005), a QRS complex >120 ms (adjOR = 19.02; 95%-CI = 2.08-175.05, p = 0.009) and female sex (adjOR = 4.24; 95%-CI = 1.08-16.64, p = 0.038) were associated with higher HRSD in the acute phase. A higher HRSD (adjOR = 1.29, 95%-CI = 1.01-1.66, p = 0.045) in the acute but not in the subacute phase (p = 0.764) was associated with poor 3-month outcome.CONCLUSION: The study suggests that a higher variation in heart rate in the early phase after ICH may discriminate patients with poor outcome.
AB - PURPOSE: Cardiac complications are common after spontaneous intracerebral hemorrhage (ICH). In this study we intended to investigate factors associated with higher alterations in heart rate and their impact on outcome.METHODS: Eighty-eight ICH patients were included. A simplified approach to calculate heart rate variability (HRSD) in analogy to systolic blood pressure variability (SBPSD) with daily standard deviations of HR in the acute (first 24 h) and subacute phase (day1-day7) was used. Using multivariable regression, factors associated with higher HRSD and the association between higher HRSD and poor 3-month outcome (modified Rankin Scale > 3) were analyzed. All models were adjusted for age, atrial fibrillation, mechanical ventilation, vasopressor administration, and mean HR.RESULTS: Patients were 71 (IQR = 60-79) years old and presented with an admission ICH-Score of 2 (IQR = 1-3). In multivariable analysis, intraventricular hemorrhage (adjOR = 8.66, 95%-CI = 1.89-39.60, p = 0.005), a QRS complex >120 ms (adjOR = 19.02; 95%-CI = 2.08-175.05, p = 0.009) and female sex (adjOR = 4.24; 95%-CI = 1.08-16.64, p = 0.038) were associated with higher HRSD in the acute phase. A higher HRSD (adjOR = 1.29, 95%-CI = 1.01-1.66, p = 0.045) in the acute but not in the subacute phase (p = 0.764) was associated with poor 3-month outcome.CONCLUSION: The study suggests that a higher variation in heart rate in the early phase after ICH may discriminate patients with poor outcome.
KW - Aged
KW - Atrial Fibrillation
KW - Blood Pressure
KW - Cerebral Hemorrhage
KW - Female
KW - Heart Rate
KW - Humans
KW - Middle Aged
UR - https://www.scopus.com/pages/publications/85095745899
U2 - 10.1016/j.jcrc.2020.10.027
DO - 10.1016/j.jcrc.2020.10.027
M3 - Article
C2 - 33186826
SN - 1557-8615
VL - 61
SP - 199
EP - 206
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -