Complexity of heart rate variability predicts outcome in intensive care unit admitted patients with acute stroke
Journal
Journal of Neurology, Neurosurgery and Psychiatry
Journal Volume
86
Journal Issue
1
Pages
95-100
Date Issued
2015
Author(s)
Hsiao-I Jen
Wei-Jung Jou
Pei-Wen Huang
Jiann-Shing Shieh
An-Yeu Wu
Abstract
Background: Heart rate variability (HRV) has been proposed as a predictor of acute stroke outcome. This study aimed to evaluate the predictive value of a novel non-linear method for analysis of HRV, multiscale entropy (MSE) and outcome of patients with acute stroke who had been admitted to the intensive care unit (ICU). Methods: The MSE of HRV was analysed from 1 h continuous ECG signals in ICU-admitted patients with acute stroke and controls. The complexity index was defined as the area under the MSE curve (scale 1-20). A favourable outcome was defined as modified Rankin scale 0-2 at 3 months after stroke. Results: The trends of MSE curves in patients with atrial fibrillation (AF) (n=77) were apparently different from those in patients with non-AF stroke (n=150) and controls (n=60). In addition, the values of complexity index were signi ficantly lower in the patients with non-AF stroke than in the controls (25.8±.3 vs 32.3±4.3, p<0.001). After adjustment for clinical variables, patients without AF who had a favourable outcome were significantly related to higher complexity index values (OR=1.15, 95% CI 1.07 to 1.25, p<0.001). Importantly, the area under the receiver operating characteristic curve for predicting a favourable outcome of patients with non-AF stroke from clinical parameters was 0.858 (95% CI 0.797 to 0.919) and signi ficantly improved to 0.903 (95% CI 0.853 to 0.954) after adding on the parameter of complexity index values ( p=0.020). Conclusions: In ICU-admitted patients with acute stroke, early assessment of the complexity of HRV by MSE can help in predicting outcomes in patients without AF. ? 2015, BMJ Publishing Group. All rights reserved.
SDGs
Type
journal article