title: Role of heart rate variability in predicting the severity of severe acute pancreatitis.
abstract: BACKGROUND
  Infected pancreatic necrosis (IPN) and multiple organ dysfunction syndrome (MODS) are major complications of acute pancreatitis which determine disease severity and outcome.
  
  
  OBJECTIVE
  The aim of this study is to investigate the value of admission heart rate variability as a marker of IPN or MODS in severe acute pancreatitis (SAP) patients.
  
  
  METHODS
  Forty-one SAP patients within 72 h of symptoms onset were included in this prospective observational study. General demographics, laboratory data and the acute physiology and chronic health evaluation (APACHE) II scores were recorded at admission. 5-minute ECG signals were obtained at the same time for heart rate variability analyses to assess SAP severity.
  
  
  RESULTS
  The baseline heart rate variability measurements, levels of low frequency/high frequency (LF/HF) were significantly lower whereas high frequency norm (nHF) levels were significantly higher in patients who present with IPN and MODS or died (P < 0.01). Low frequency (LF) levels were lower in patients who present with IPN or MODS as compared to patients without these complications. Levels of low frequency norm (nLF) were lower in MODS and non-survival patients. nHF and LF/HF were good predictors of IPN and MODS, superior to procalcitonin. nHF and LF/HF were better than APACHE II in predicting IPN and LF/HF showed superiority over APACHE II in the prediction of MODS.
  
  
  CONCLUSIONS
  Admission heart rate variability is a good marker of IPN and MODS in SAP patients.
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, Jiangsu Province, China, mariolw@outlook.com.
authors.forename: Luyao
authors.initials: L
authors.lastname: Zhang
authors.forename: Jing
authors.initials: J
authors.lastname: Zhou
authors.forename: Lu
authors.initials: L
authors.lastname: Ke
authors.forename: Yao
authors.initials: Y
authors.lastname: Nie
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Tong
authors.forename: Weiqin
authors.initials: W
authors.lastname: Li
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D015415:Biomarkers; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies
chemical_list: D015415:Biomarkers