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A novel vital sign pattern predicts sepsis-related myocardial injury mortality. | LitMetric

AI Article Synopsis

  • Researchers are aiming to create non-invasive, real-time indicators to assess heart injury related to sepsis, using heart rate and diastolic pressure monitors.
  • In a study involving over 20,000 patients, it was found that survival rates were highest when heart rate was below 90 bpm or diastolic arterial pressure was between 50 and 70 mmHg.
  • A specific high-risk exposure pattern identified, characterized by a heart rate of 90 bpm or more coupled with diastolic pressure of 50 mmHg or lower, significantly increased mortality risk when glucocorticoids were used.

Article Abstract

Non-invasive, real-time monitorable indicators for early assessment of sepsis-associated myocardial injury (SMI) are still lacking. We aimed to develop non-invasive, real-time indicators for early assessment of SMI using bedside heart rate (HR) and diastolic arterial pressure (DAP) monitors. In this multi-center cohort study, piece-wise exponential additive mixed models were used to estimate the exposure window and time fraction of the hazardous exposure proportion, and secondarily to analyze the exposure characterization on this basis to identify high-risk exposure pattern. In total, 20,043 patients were finally included; we found that SMI patients had the highest survival rate when HR was <90 bpm or DAP was between 50 and 70 mmHg. Further investigation revealed that the SMI high-risk exposure pattern was the HD (HR ≥ 90 bpm and DAP ≤ 50 mmHg, exposure proportion > 0.3 and 0.2, respectively, and exposure window on admission day 1). HD exposure pattern using glucocorticoids significantly increased the risk of mortality in HD. Validation against various methodologies and data sources demonstrated acceptable consistency.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414694PMC
http://dx.doi.org/10.1016/j.isci.2024.110787DOI Listing

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