title: Heart Rate Variability as a Predictor of Death in Burn Patients.
abstract: Heart rate variability (HRV), a noninvasive technique used to quantify fluctuations in the interval between normal heart beats (NN), is a predictor of mortality in some patient groups. The aim of this study was to assess HRV in burn trauma patients as a predictor of mortality. The authors prospectively performed 24-hour Holter monitoring on burn patients and collected demographic information, burn injury details, and in-hospital clinical events. Analysis of HRV in the time and frequency domains was performed. A total of 40 burn patients with a mean age of 44 ± 15 years were enrolled. Mean %TBSA burn was 27 ± 22% for the overall population and was significantly higher in those who died compared with those who survived (55 ± 23% vs 19 ± 13%; P < .0001). There was a statistically significant inverse linear correlation between SD of NN intervals and %TBSA (r = -.337, R = 0.113, 95% CI = -0.587 to -0.028, two-tailed P = .034), as well as with ultra low frequency power and %TBSA burn (r = -0.351, R = 0.123, 95% CI = -0.152 to -0.009; P = .027). The receiver-operator characteristic showed the area under the curve for %TBSA as a predictor of death was 0.82 (P < .001), for SDANN was 0.94 (P < .0001), and for ultra low frequency power was 0.96 (P < .0001). Deranged HRV in the early postburn period is a strong predictor of death.
authors.affiliation: From the *Department of Medicine, †Division of Cardiology, University of Virginia, Charlottesville; ‡Houston Methodist DeBakey Heart & Vascular Center, Texas; and §Department of Surgery, University of Texas Southwestern Medical Center, Dallas.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Loguidice
authors.forename: Robert C
authors.initials: RC
authors.lastname: Schutt
authors.forename: Jureta W
authors.initials: JW
authors.lastname: Horton
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Minei
authors.forename: Ellen C
authors.initials: EC
authors.lastname: Keeley
mesh_terms: D000328:Adult; D002056:Burns / Q000401:mortality*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies