title: Heart rate variability measures as predictors of in-hospital mortality in ED patients with sepsis.
abstract: OBJECTIVE
  To determine the predictive capability of heart rate variability (HRV) measures of patients with sepsis in the ED for in-hospital death.
  
  
  METHODS
  This was a prospective, observational study. A consecutive cohort of patients visiting the ED of a university teaching hospital who met the criteria of sepsis over a 6-month period were enrolled in this study. General demographics, vital signs, laboratory data, and Mortality in Emergency Department Sepsis score were obtained in the ED; the in-patient medical record was reviewed; and a series of continuous 10-minute electrocardiographic signals were recorded for off-line HRV analysis to assess the in-hospital mortality of the patients.
  
  
  RESULTS
  One hundred thirty-two patients aged 27 to 86 years who met the inclusion criteria were enrolled. According to the in-hospital outcome, the patients were categorized into 2 groups: nonsurvivors (n = 10) and survivors (n = 122). The baseline HRV measures, including SDNN, TP, VLFP, LFP, and LFP/HFP ratio, of nonsurvivors were significantly lower, whereas the nHFP was significantly higher, than those of survivors. Multiple logistic regression model identified SDNN and nHFP as the significant independent variables in the prediction of in-hospital mortality for ED patients with sepsis. The receiver operating characteristic area for SDNN and nHFP in predicting the risk of death was 0.700 and 0.739, respectively.
  
  
  CONCLUSIONS
  Heart rate variability measures, especially the SDNN and nHFP, may be used as valuable predictors of in-hospital mortality in patients with sepsis attending the ED.
authors.affiliation: Department of Emergency Medicine, Cathay General Hospital, Taipei 10630, Taiwan.
authors.forename: Wei-Lung
authors.initials: WL
authors.lastname: Chen
authors.forename: Jiann-Hwa
authors.initials: JH
authors.lastname: Chen
authors.forename: Chien-Cheng
authors.initials: CC
authors.lastname: Huang
authors.forename: Cheng-Deng
authors.initials: CD
authors.lastname: Kuo
authors.forename: Chun-I
authors.initials: CI
authors.lastname: Huang
authors.forename: Liang-Shong
authors.initials: LS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D006339:Heart Rate; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018805:Sepsis / Q000401:mortality* / Q000503:physiopathology*