1. Early alterations in heart rate are associated with poor outcome in patients with intracerebral hemorrhage.
- Author
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Rass V, Lindner A, Ianosi BA, Schiefecker AJ, Loveys S, Kofler M, Rass S, Pfausler B, Beer R, Schmutzhard E, and Helbok R
- Subjects
- Aged, Blood Pressure, Female, Heart Rate, Humans, Middle Aged, Atrial Fibrillation, Cerebral Hemorrhage
- Abstract
Purpose: Cardiac complications are common after spontaneous intracerebral hemorrhage (ICH). In this study we intended to investigate factors associated with higher alterations in heart rate and their impact on outcome., Methods: Eighty-eight ICH patients were included. A simplified approach to calculate heart rate variability (HR
SD ) in analogy to systolic blood pressure variability (SBPSD ) with daily standard deviations of HR in the acute (first 24 h) and subacute phase (day1-day7) was used. Using multivariable regression, factors associated with higher HRSD and the association between higher HRSD and poor 3-month outcome (modified Rankin Scale > 3) were analyzed. All models were adjusted for age, atrial fibrillation, mechanical ventilation, vasopressor administration, and mean HR., Results: Patients were 71 (IQR = 60-79) years old and presented with an admission ICH-Score of 2 (IQR = 1-3). In multivariable analysis, intraventricular hemorrhage (adjOR = 8.66, 95%-CI = 1.89-39.60, p = 0.005), a QRS complex >120 ms (adjOR = 19.02; 95%-CI = 2.08-175.05, p = 0.009) and female sex (adjOR = 4.24; 95%-CI = 1.08-16.64, p = 0.038) were associated with higher HRSD in the acute phase. A higher HRSD (adjOR = 1.29, 95%-CI = 1.01-1.66, p = 0.045) in the acute but not in the subacute phase (p = 0.764) was associated with poor 3-month outcome., Conclusion: The study suggests that a higher variation in heart rate in the early phase after ICH may discriminate patients with poor outcome., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2020. Published by Elsevier Inc.)- Published
- 2021
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