Association between non-acute traumatic injury (TI) and heart rate variability (HRV) in adults: A systematic review protocol

Maqsood, Rabeea; Khattab, Ahmed; Bennett, Alexander N.; Boos, Christopher J.

doi:10.1371/journal.pone.0273688

Cited by 1 publication

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“…To date, it is the first systematic review to examine the association between non-acute TI and HRV in adults. This systematic review has been conducted in a transparent manner using the PRISMA guidelines since its registration on the PROSPERO database and the publication of its protocol [ 32 ]. The quality of evidence has also been assessed using GRADE.…”

Section: Discussionmentioning

confidence: 99%

“…The protocol of this systematic review is registered at PROSPERO (CRD: CRD42021298530. The protocol for this systematic review has been recently published [ 32 ] ( S1 Protocol ). This systematic review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines and checklist [ 33 ] ( S1 Table ).…”

Section: Methodsmentioning

confidence: 99%

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Association between non-acute Traumatic Injury (TI) and Heart Rate Variability (HRV) in adults: A systematic review and meta-analysis

et al. 2023

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Heart rate variability (HRV) is a non-invasive measure of autonomic function. The relationship between unselected long-term traumatic injury (TI) and HRV has not been investigated. This systematic review examines the impact of non-acute TI (>7 days post-injury) on standard HRV indices in adults. Four electronic databases (CINAHL, Medline, Scopus, and Web of Science) were searched. The quality of studies, risk of bias (RoB), and quality of evidence (QoE) were assessed using Axis, RoBANS and GRADE, respectively. Using the random-effects model, mean difference (MD) for root mean square of successive differences (RMSSD) and standard deviation of NN-intervals (SDNN), and standardized mean difference (SMD) for Low-frequency (LF): High-Frequency (HF) were pooled in RevMan guided by the heterogeneity score (I2). 2152 records were screened followed by full-text retrieval of 72 studies. 31 studies were assessed on the inclusion and exclusion criteria. Only four studies met the inclusion criteria. Three studies demonstrated a high RoB (mean RoBANS score 14.5±3.31) with a low QoE. TI was associated with a significantly higher resting heart rate. Meta-analysis of three cross-sectional studies demonstrated a statistically significant reduction in RMSSD (MD -8.45ms, 95%CI-12.78, -4.12, p<0.0001) and SDNN (MD -9.93ms, 95%CI-14.82, -5.03, p<0.0001) (low QoE) in participants with TI relative to the uninjured control. The pooled analysis of four studies showed a higher LF: HF ratio among injured versus uninjured (SMD 0.20, 95%CI 0.01–0.39, p<0.04) (very low QoE). Albeit low QoE, non-acute TI is associated with attenuated HRV indicating autonomic imbalance. The findings might explain greater cardiovascular risk following TI. Trial registration PROSPERO registration number: CRD: CRD42021298530.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%