OBJECTIVE: We have previously shown that cardiac uncoupling (reduced heart rate variability) in the first 24 hours of trauma ICU stay is a robust predictor of mortality. We hypothesize that cardiac uncoupling over the entire ICU stay independently predicts mortality, reveals patterns of injury, and heralds complications. METHODS: A total of 2088 trauma ICU patients satisfied the inclusion criteria for this study. Cardiac uncoupling by outcome was compared using the Wilcoxon rank sum test. Risk of death from cardiac uncoupling and covariates (age, ISS, AIS Head Score, total transfusion requirements) was assessed using multivariate logistic regression models at each ICU day. Univariate logistic regression was used to assess risk of death from uncoupling irrespective of covariates at each ICU day. RESULTS: A total of 1325 (63.5%) patients displayed some degree of uncoupling over their ICU stay. The difference in uncoupling between survivors and nonsurvivors is both dramatic and consistent across the entire ICU stay, indicating that the presence of uncoupling is unrelated to the cause of death. However, the magnitude of uncoupling varies by day when data is stratified by cause of death. CONCLUSIONS: Cardiac uncoupling: 1) is an independent predictor of death throughout the ICU stay, 2) has a predictive window of 2 to 4 days, and 3) appears to increase in response to inflammation, infection, and multiple organ failure.
OBJECTIVE: We have previously shown that cardiac uncoupling (reduced heart rate variability) in the first 24 hours of trauma ICU stay is a robust predictor of mortality. We hypothesize that cardiac uncoupling over the entire ICU stay independently predicts mortality, reveals patterns of injury, and heralds complications. METHODS: A total of 2088 trauma ICUpatients satisfied the inclusion criteria for this study. Cardiac uncoupling by outcome was compared using the Wilcoxon rank sum test. Risk of death from cardiac uncoupling and covariates (age, ISS, AIS Head Score, total transfusion requirements) was assessed using multivariate logistic regression models at each ICU day. Univariate logistic regression was used to assess risk of death from uncoupling irrespective of covariates at each ICU day. RESULTS: A total of 1325 (63.5%) patients displayed some degree of uncoupling over their ICU stay. The difference in uncoupling between survivors and nonsurvivors is both dramatic and consistent across the entire ICU stay, indicating that the presence of uncoupling is unrelated to the cause of death. However, the magnitude of uncoupling varies by day when data is stratified by cause of death. CONCLUSIONS: Cardiac uncoupling: 1) is an independent predictor of death throughout the ICU stay, 2) has a predictive window of 2 to 4 days, and 3) appears to increase in response to inflammation, infection, and multiple organ failure.
Authors: L V Borovikova; S Ivanova; M Zhang; H Yang; G I Botchkina; L R Watkins; H Wang; N Abumrad; J W Eaton; K J Tracey Journal: Nature Date: 2000-05-25 Impact factor: 49.962
Authors: Eric L Grogan; Patrick R Norris; Theodore Speroff; Asli Ozdas; Daniel J France; Paul A Harris; Judith M Jenkins; Renee Stiles; Robert S Dittus; John A Morris Journal: J Trauma Date: 2005-01
Authors: D Liao; R P Sloan; W E Cascio; A R Folsom; A D Liese; G W Evans; J Cai; A R Sharrett Journal: Diabetes Care Date: 1998-12 Impact factor: 19.112
Authors: J Nolan; P D Batin; R Andrews; S J Lindsay; P Brooksby; M Mullen; W Baig; A D Flapan; A Cowley; R J Prescott; J M Neilson; K A Fox Journal: Circulation Date: 1998-10-13 Impact factor: 29.690
Authors: Stephen C Gale; Beth-Ann Shanker; Susette M Coyle; Marie A Macor; Chun W Choi; Steve E Calvano; Siobhan A Corbett; Stephen F Lowry Journal: Shock Date: 2012-08 Impact factor: 3.454
Authors: Amani D Politano; Lin M Riccio; Douglas E Lake; Craig G Rusin; Lauren E Guin; Christopher S Josef; Matthew T Clark; Robert G Sawyer; J Randall Moorman; James F Calland Journal: Surgery Date: 2013-09-26 Impact factor: 3.982
Authors: Badar U Jan; Susette M Coyle; Marie A Macor; Michael Reddell; Steve E Calvano; Stephen F Lowry Journal: Shock Date: 2010-04 Impact factor: 3.454
Authors: Flora M Hammond; John D Corrigan; Jessica M Ketchum; James F Malec; Kristen Dams-OʼConnor; Tessa Hart; Thomas A Novack; Jennifer Bogner; Marie N Dahdah; Gale G Whiteneck Journal: J Head Trauma Rehabil Date: 2019 Jul/Aug Impact factor: 2.710
Authors: Badar U Jan; Susette M Coyle; Leo O Oikawa; Shou-En Lu; Steve E Calvano; Paul M Lehrer; Stephen F Lowry Journal: Ann Surg Date: 2009-05 Impact factor: 12.969
Authors: Leopoldo C Cancio; Andriy I Batchinsky; William L Baker; Corina Necsoiu; José Salinas; Ary L Goldberger; Madalena D Costa Journal: J Crit Care Date: 2013-10-17 Impact factor: 3.425