Autonomic nervous system activity as risk predictor in the medical emergency department: a prospective cohort study

Critical Care Medicine
Christian EickAxel Bauer

Abstract

To evaluate heart rate deceleration capacity, an electrocardiogram-based marker of autonomic nervous system activity, as risk predictor in a medical emergency department and to test its incremental predictive value to the modified early warning score. Prospective cohort study. Medical emergency department of a large university hospital. Five thousand seven hundred thirty consecutive patients of either sex in sinus rhythm, who were admitted to the medical emergency department of the University of Tübingen, Germany, between November 2010 and March 2012. None. Deceleration capacity of heart rate was calculated within the first minutes after emergency department admission. The modified early warning score was assessed from respiratory rate, heart rate, systolic blood pressure, body temperature, and level of consciousness as previously described. Primary endpoint was intrahospital mortality; secondary endpoints included transfer to the ICU as well as 30-day and 180-day mortality. One hundred forty-two patients (2.5%) reached the primary endpoint. Deceleration capacity was highly significantly lower in nonsurvivors than survivors (2.9 ± 2.1 ms vs 5.6 ± 2.9 ms; p < 0.001) and yielded an area under the receiver-operator characteristic ...Continue Reading

Associated Clinical Trials

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Citations

Mar 24, 2017·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·C EickAxel Bauer
Sep 1, 2017·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Anezi I UzenduFadi G Hage
Feb 23, 2017·World Journal of Critical Care Medicine·Thu An NguyenAdam M Deane
Jul 11, 2018·High Altitude Medicine & Biology·Wolfgang HammStefan Brunner
May 17, 2019·BMC Medical Informatics and Decision Making·James MalychaPeter J Watkinson
Apr 8, 2020·Scandinavian Journal of Medicine & Science in Sports·Wolfgang HammStefan Brunner
Jul 14, 2017·Intensive Care Medicine Experimental·Shamir N KarmaliGareth L Ackland
Nov 7, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Konstantinos D RizasAxel Bauer
Jun 26, 2021·Scientific Reports·Stefan BrunnerMoritz F Sinner
Aug 25, 2021·Heart & Lung : the Journal of Critical Care·Lars MizeraMartin Duckheim

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