Sunghoon Park1, Dong-Gyu Kim1, Gee Young Suh2, Woo Jung Park3, Seung Hun Jang1, Yong Il Hwang1, Sang-Jin Han3, Hyun Hee Jeong4, Chang-Hoon Lee5, Ki-Suck Jung6. 1. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896 Anyang, Gyeonggi-do, Republic of Korea. 2. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Seoul, Republic of Korea. 3. Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896 Anyang, Gyeonggi-do, Republic of Korea. 4. Department of Nursing, Hallym University Sacred Heart Hospital, 896 Anyang, Gyeonggi-do, Republic of Korea. 5. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 39 Boramae-gil, Seoul, Republic of Korea. 6. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896 Anyang, Gyeonggi-do, Republic of Korea. Electronic address: pulmoks@hallym.or.kr.
Abstract
OBJECTIVE: Few data are available on sinus tachycardia among medical intensive care unit (ICU) patients. We investigated new critical illnesses related to new-onset prolonged sinus tachycardia (NOPST) and the relationship of NOPST with ICU mortality. METHODS: The heart rate (HR) of all enrolled patients was monitored hourly over a 12-month period, and NOPST was defined as sinus tachycardia (>100 beats/min) with an increase in HR of more than 20% from the baseline value lasting longer than 6 hours. RESULTS: Among the 522 patients enrolled, the average mean HR was 96.1 ± 18.4 beats/min. Fifty-two (10.0%) patients met the criteria for NOPST; pneumonia, delirium, septic shock, acute respiratory distress syndrome, catheter-related infections, and mechanical ventilator-related problems were related to the occurrence of NOPST. The ICU mortality rate in patients with a NOPST duration of more than 72 hours was higher compared with other patients with NOPST (60.0% vs 18.5%; P = .002). A high daily mean HR rather than NOPST was a significant predictor of ICU mortality (odds ratio, 1.415; 95% confidence interval, 1.177-1.700). CONCLUSIONS: Although NOPST was not associated with ICU mortality, it indicates the presence of new critical events in the medical ICU setting.
OBJECTIVE: Few data are available on sinus tachycardia among medical intensive care unit (ICU) patients. We investigated new critical illnesses related to new-onset prolonged sinus tachycardia (NOPST) and the relationship of NOPST with ICU mortality. METHODS: The heart rate (HR) of all enrolled patients was monitored hourly over a 12-month period, and NOPST was defined as sinus tachycardia (>100 beats/min) with an increase in HR of more than 20% from the baseline value lasting longer than 6 hours. RESULTS: Among the 522 patients enrolled, the average mean HR was 96.1 ± 18.4 beats/min. Fifty-two (10.0%) patients met the criteria for NOPST; pneumonia, delirium, septic shock, acute respiratory distress syndrome, catheter-related infections, and mechanical ventilator-related problems were related to the occurrence of NOPST. The ICU mortality rate in patients with a NOPST duration of more than 72 hours was higher compared with other patients with NOPST (60.0% vs 18.5%; P = .002). A high daily mean HR rather than NOPST was a significant predictor of ICU mortality (odds ratio, 1.415; 95% confidence interval, 1.177-1.700). CONCLUSIONS: Although NOPST was not associated with ICU mortality, it indicates the presence of new critical events in the medical ICU setting.
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