Does heart rate really predict survival in septic shock?
BACKGROUND
Normalisation of heart rate after 24 hours of treatment is proposed to predict the survival outcome in septic shock patients.


METHODS
The medical and surgical patients charts from 1991-1993 were selected for the diagnosis of septic shock (according to the definition of ACCP/SCCM Consensus Conference), and reviewed. Also included were patients with available variables to complete APACHE II and septic severity score.


RESULTS
Tachycardia was observed more in the non-survivors (9 patients) both in shock (107.8 vs 93.4) and non-shock states (112.3 vs 93.2). Heart rate in the survival group decreased below the cut-off value, which is 95 beats/min, as specified by ACCP/SCCM. Comparison between APACHE II and SSS was not well correlated because of the small sample size. Elements in creating a predictor and its categorisation are mentioned.


CONCLUSIONS
Heart rate was concluded to be a simple predictor reflecting physiologic derangements in septic shock. It is recommended that further study needs to be carried out to unravel a predictor of clinical value in terms of practicality, especially that involving the inflammatory aspect of the disease process.
Sukavejvorakit
M
M
Department of Medicine, Sawanpracharak Hospital, Nakornsawan, Thailand.
Tantivitayatan
K
K
D018806:APACHE; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D015996:Survival Rate