Perioperative medicine & outcomes
Prognostic value of heart rate variability for risk of serious adverse events in continuously monitored hospital patients
Authors' conclusion
Predicting SAEs based on the accumulated time below thresholds for individual continuously measured HRV parameters demonstrated overall low prognostic ability in high-risk hospitalized patients.
Study context
- Population
- Acute medical and major surgical patients with continuous vital sign monitoring at the general ward1,402 assessed
- Participants
- 923 participants
- Comparison
- Last 24 h before an serious adverse events (SAE) vs last 24 h of measurements in patients without an SAE
- Outcome
- Any SAE
- Follow-up
- 30 days
Methodological detailspooled analysis of four prospective observational studies and two RCTs, continuous single-lead ECG monitoring, subgroup analyses (medical, surgical)
- Pooled analysis of four prospective observational studies and two RCTs
- Continuous single-lead ECG monitoring
- Subgroup analyses (medical, surgical)
Performance
As reported in the abstract
Prediction of SAEs by heart rate variability (HRV) thresholds (AUROC)
Patients with at least one SAE
297
32%
Best performing threshold AUROC for cardiovascular SAEs
0.67
95% CI 0.63–0.71
Secondary outcomes
Neurologic SAE prediction, surgical subgroup
- Best performing threshold AUROC
- 0.70 (95% CI 0.60-0.81)
Neurologic SAE prediction, medical subgroup
- Best performing threshold AUROC
- 0.85 (95% CI 0.76-0.95)
- Thresholds for all-cause mortality, cardiovascular, infectious and neurologic SAEs had moderate prognostic ability
Original publication
Prognostic value of heart rate variability for risk of serious adverse events in continuously monitored hospital patients. J Clin Monit Comput. Published 20 August 2024. doi:10.
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