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. 2024 Dec 26;14(12):e087725.
doi: 10.1136/bmjopen-2024-087725.

Efficacy in predicting mortality of patients with heart failure using heart rate before intensive care unit discharge: a retrospective cohort study from MIMIC-IV Database

Chia-Ying Hsiao  1   2 , Min-I Su  2   3   4 , Yu-Cheng Chang  5   6 , Ying-Hsiang Lee  2   7   8 , Po-Lin Lin  9   10 , Wei-Ru Chiou  11   3
Affiliations

Efficacy in predicting mortality of patients with heart failure using heart rate before intensive care unit discharge: a retrospective cohort study from MIMIC-IV Database

Chia-Ying Hsiao et al. BMJ Open. .

Abstract

Objective: Heart rate serves as a critical prognostic factor in heart failure (HF) patients. We hypothesise that elevated heart rate in critically ill HF patients on discharge from the intensive care unit (ICU) could be linked to adverse outcomes.

Design: A single-centre retrospective cohort study.

Setting: This study used data collected between 2008 and 2019 from the Medical Information Mart for Intensive Care IV (V.2.0) Database.

Participants: From the 76 943 ICU stays, we enrolled 2365 patients in this study.

Primary and secondary outcome measures: We observed correlations between in-hospital mortality and ICU discharge heart rate of 83.56±15.81 beats per minute (bpm) (survivors) vs 93.84±17.28 bpm (non-survivors, p<0.001). Total mortality showed similar trends, with 83.67±15.36 bpm (survivors) vs 85.23±17.25 bpm (non-survivors, p=0.027), as did ICU readmissions at 83.55±15.77 bpm (non-readmitted) vs 88.64±17.49 bpm (readmitted, p<0.001).

Results: Given multivariate analysis, the ICU discharge heart rate strongly predicted in-hospital mortality (HR 1.032 (95% CI 1.022 to 1.041), p<0.001), total mortality (HR 1.008 (95% CI 1.004 to 1.013), p<0.001) and ICU readmission (HR 1.018 (95% CI 1.010 to 1.025), p<0.001). Patients with an ICU discharge heart rate>90 bpm demonstrated significantly higher in-hospital mortality (HR 2.639 (95% CI 1.898 to 3.669), p<0.001), total mortality (HR 1.342 (95% CI 1.163 to 1.550), p<0.001) and ICU readmission rates (HR 1.781 (95% CI 1.413 to 2.243), p<0.001).

Conclusion: The findings suggest that HF patients with an elevated heart rate (>90 bpm) at ICU discharge are more likely to experience increased in-hospital mortality, total mortality and ICU readmissions, indicating potential negative outcomes.

Keywords: Adult intensive & critical care; Heart failure; Retrospective Studies; Risk management.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Study flowchart. ICD-10, International Classification of Diseases, 10th Revision; ICU, intensive care unit; MIMIC-IV, Medical Information Mart for Intensive Care IV.
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References

    1. Hoke RS, Müller-Werdan U, Lautenschläger C, et al. Heart rate as an independent risk factor in patients with multiple organ dysfunction: a prospective, observational study. Clin Res Cardiol . 2012;101:139–47. doi: 10.1007/s00392-011-0375-3. - DOI - PubMed
    1. Sander O, Welters ID, Foëx P, et al. Impact of prolonged elevated heart rate on incidence of major cardiac events in critically ill patients with a high risk of cardiac complications. Crit Care Med. 2005;33:81–8. doi: 10.1097/01.ccm.0000150028.64264.14. - DOI - PubMed
    1. Chioncel O, Ambrosy AP, Filipescu D, et al. Patterns of intensive care unit admissions in patients hospitalized for heart failure. J Cardiovasc Med (Hagerstown) 2015;16:331–40. doi: 10.2459/JCM.0000000000000030. - DOI - PubMed
    1. Lai J-I, Lin H-Y, Lai Y-C, et al. Readmission to the intensive care unit: a population-based approach. J Formos Med Assoc. 2012;111:504–9. doi: 10.1016/j.jfma.2011.06.012. - DOI - PubMed
    1. Opdahl A, Ambale Venkatesh B, Fernandes VRS, et al. Resting heart rate as predictor for left ventricular dysfunction and heart failure: MESA (Multi-Ethnic Study of Atherosclerosis) J Am Coll Cardiol. 2014;63:1182–9. doi: 10.1016/j.jacc.2013.11.027. - DOI - PMC - PubMed