Lower heart rate is associated with good one-year outcome in post-resuscitation patients

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FINNRESUSCI Study Grp , Oksanen , T , Tiainen , M , Vaahersalo , J , Bendel , S , Varpula , T , Skrifvars , M , Pettilä , V & Wilkman , E 2018 , ' Lower heart rate is associated with good one-year outcome in post-resuscitation patients ' , Resuscitation , vol. 128 , pp. 112-118 . https://doi.org/10.1016/j.resuscitation.2018.05.001

Title: Lower heart rate is associated with good one-year outcome in post-resuscitation patients
Author: FINNRESUSCI Study Grp; Oksanen, Tuomas; Tiainen, Marjaana; Vaahersalo, Jukka; Bendel, Stepani; Varpula, Tero; Skrifvars, Markus; Pettilä, Ville; Wilkman, Erika
Contributor: University of Helsinki, Anestesiologian yksikkö
University of Helsinki, Neurologian yksikkö
University of Helsinki, Anestesiologian yksikkö
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, Clinicum
Date: 2018-07
Language: eng
Number of pages: 7
Belongs to series: Resuscitation
ISSN: 0300-9572
URI: http://hdl.handle.net/10138/301649
Abstract: Background: Optimal hemodynamic goals in post-resuscitation patients are not clear. Previous studies have reported an association between lower heart rate and good outcome in patients receiving targeted temperature management (TTM) after out-of-hospital cardiac arrest. Methods: We analyzed heart rate (HR) and outcome data of 504 post-resuscitation patients from the prospectively collected database of the FINNRESUSCI study. One-year neurologic outcome was dichotomized by the Cerebral Performance Category (CPC) to good (1-2) or poor (3-5). Results: Of 504 patients, 40.1% (202/504) had good and 59.9% (302/504) had poor one-year neurologic outcome. Patients with good outcome had lower time-weighted mean HR during the first 48 h in the ICU (69.2 bpm [59.2-75.1] vs. 76.6 bpm [65.72-89.6], p <0.001) and the first 72 h in the ICU (71.2 bpm [65.0-79.0] vs. 77.1 bpm [69.1-90.1, p <0.001]). The percentage of HR registrations below HR threshold values (60, 80 and 100 bpm) were higher for patients with good neurologic outcome, p <0.001 for all. Lower time-weighted HR for 0-48 h and 0-72 h, and a higher percentage of HR recordings below threshold values were independently associated with good neurological one-year outcome (p <0.05 for all). When TTM and non-TTM patients were analyzed separately, HR parameters were independently associated with one-year neurologic outcome only in non-TTM patients. Conclusion: Lower heart rate was independently associated with good neurologic outcome. Whether HR in post-resuscitation patients is a prognostic indicator or an important variable to be targeted by treatment, needs to be assessed in future prospective controlled clinical trials.
Subject: Postresuscitation
Haemodynamics
Heart rate
Bradycardia
Outcome
Hypothermia
Therapeutic temperature management
HOSPITAL CARDIAC-ARREST
ELEVATION MYOCARDIAL-INFARCTION
THERAPEUTIC HYPOTHERMIA
RATE-VARIABILITY
BETA-BLOCKERS
RESUSCITATION
CARE
METAANALYSIS
SURVIVAL
FIBRILLATION
3126 Surgery, anesthesiology, intensive care, radiology
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