RESEARCHERS have identified a J-shaped association between mean heart rate (MHR) and 30-day mortality in older patients with sepsis in the ICU, meaning that mortality risk decreases as MHR approaches an optimal range (73-82 bpm), but then increases to levels higher than the initial risk when the heart rate rises above this range.
Researchers conducted a retrospective study that included 6,598 patients aged 65 or older with sepsis at their first ICU admission, using data from the MIMIC-IV database. The research team assessed MHR during the first 24 hours of ICU admission and analysed the relationship with 30-day mortality using advanced statistical models like multivariable Cox regression and restricted cubic splines. Of the participants, 19.6% (1,295 patients) died within 30 days of admission. The analysis revealed a J-shaped association between MHR and mortality risk, with an inflection point around 74 bpm. The lowest mortality risk was observed for patients whose MHR fell between 73 and 82 bpm.
This study’s findings suggest that MHR is a significant predictor of 30-day mortality in older ICU patients with sepsis. A heart rate between 73 and 82 bpm was associated with the lowest mortality risk, highlighting a potential target for heart rate management in these patients. Future studies should focus on confirming these findings and investigating whether interventions to maintain heart rate within this range could improve patient outcomes.
Katrina Thornber, EMJ
Reference
Zhou Q et al. Effect of mean heart rate on 30-day mortality in older patients with sepsis: Data from the MIMIC-IV database. Am J Med Sci. 2024;DOI:10.1016/j.amjms.2024.08.006.
