Heart Rate Variability and Its Association with Mortality in Prehospital Trauma Patients

Abstract

Background: Accurate prehospital triage of trauma patients is difficult, especially in mass casualty situations. Accordingly, the U.S. Military has initiated a program directed toward improving noninvasive prehospital triage algorithms based on available physiologic data. The purpose of this study was to assess heart rate variability and its association with mortality in prehospital trauma patients. Methods: Trauma patients without significant head injury requiring helicopter transport were identified from a retrospective research database. An equal number, unmatched sample of patients who lived were compared with those who died (n 15 per group). All patients were transported to a single Level I urban trauma center. The primary independent variable was mortality. Patients with Abbreviated Injury Scale head scores greater than 2 were excluded from the analysis, so that the effects seen were based on hemorrhagic shock. Age, sex, Glasgow Coma Scale score (GCS), blood pressure, pulse pressure, pulse, intubation rate, SpO2, mechanism of injury, transport time, and time of death after admission were recorded. R-waves from the first available 120 seconds of usable data were detected from normal electrocardiograms and heart rate variability was assessed. Results: Patients who died demonstrated a lower GCS (7.9 + or - 1.4 versus 14.4 + or - 0.2; p = 0.0001) and higher intubation rate (53% of patients who died versus 0% patients who lived). Pulse rate, arterial pressure, and SpO2 were not distinguishable statistically between groups (p = 0.08), but pulse pressure was lower in patients who died (39 + or - 3 versus 50 + or - 2 mm Hg; p = 0.01).

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Document Details

Document Type
Technical Report
Publication Date
Feb 01, 2006
Accession Number
ADA628012

Entities

People

  • David A. Ludwig
  • Denise Hinds
  • Fredrick A. Moore
  • James H. Duke
  • John B Holcomb
  • Josè Salinas
  • Victor A Convertino
  • William H. Cooke

Organizations

  • United States Army Institute of Surgical Research

Tags

DTIC Thesaurus Topics

  • Cardiovascular Physiological Phenomena
  • Data Analysis
  • Data Sets
  • Databases
  • Electrocardiography
  • First Responders
  • Frequency
  • Frequency Domain
  • Health Services
  • Heart Rate
  • Hemorrhage
  • Hemorrhagic Shock
  • Hospitals
  • Information Science
  • Medical Personnel
  • Patient Care
  • Vital Signs

Fields of Study

  • Medicine

Readers

  • Cardiovascular Physiology
  • Mathematics or Statistics
  • Trauma or Military Medicine