https://scholars.lib.ntu.edu.tw/handle/123456789/590494
標題: | Complexity of heart rate variability predicts outcome in intensive care unit admitted patients with acute stroke | 作者: | SUNG-CHUN TANG Hsiao-I Jen YEN-HUNG LIN CHI-SHENG HUNG Wei-Jung Jou Pei-Wen Huang Jiann-Shing Shieh YI-LWUN HO DAR-MING LAI An-Yeu Wu JIANN-SHING JENG MING-FONG CHEN AN-YEU(ANDY) WU |
公開日期: | 2015 | 卷: | 86 | 期: | 1 | 起(迄)頁: | 95-100 | 來源出版物: | Journal of Neurology, Neurosurgery and Psychiatry | 摘要: | 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. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84919774207&doi=10.1136%2fjnnp-2014-308389&partnerID=40&md5=2a6e0ea5d68d0f7625c5ae6aa57fdc6a https://scholars.lib.ntu.edu.tw/handle/123456789/590494 |
ISSN: | 223050 | DOI: | 10.1136/jnnp-2014-308389 | SDG/關鍵字: | adult; age; aged; area under the curve; Article; blood pressure monitoring; case control study; cerebrovascular accident; controlled study; electrocardiogram; electrocardiograph; entropy; evaluation study; female; heart atrium fibrillation; heart rate variability; human; hypertension; intensive care unit; major clinical study; male; multiscale entropy; predictive value; prospective study; Rankin scale; receiver operating characteristic; sensitivity and specificity; treatment outcome; trend study; cerebrovascular accident; complication; electrocardiography; heart atrium fibrillation; heart rate; middle aged; nonlinear system; outcome assessment; pathophysiology; physiology; risk factor; Aged; Atrial Fibrillation; Case-Control Studies; Electrocardiography; Entropy; Heart Rate; Humans; Intensive Care Units; Male; Middle Aged; Nonlinear Dynamics; Outcome Assessment (Health Care); Predictive Value of Tests; Prospective Studies; Risk Factors; Stroke |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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