Circadian rhythms of vital signs are associated with in-hospital mortality in critically ill patients: A retrospective observational study

Yang, Zhengning; Xie, Xiaoqing; Zhang, Xu; Li, Lan; Bai, Ruoxue; Liu, Hui; Ma, Yanna; Hui, Zhenliang; Qi, Yujie

doi:10.1080/07420528.2022.2163656

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…For example, do these peak-to-trough excursions correlate with patient health status, and if so, can they be used as part of the decision-making process in patient discharge? EHR studies suggest that reduced day–night differences in vital signs are associated with increased mortality in hospitalized patients [ 49 – 53 ], but not all studies agree [ 54 ]. Future research is needed to understand if and how 24-hour physiology tracks health and predicts outcomes.…”

Section: Opportunities For the Use Of Ehr In Circadian Medicinementioning

confidence: 99%

Using routinely collected clinical data for circadian medicine: A review of opportunities and challenges

Kervezee,

Dashti,

Pilz

et al. 2024

PLOS Digit Health

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A wealth of data is available from electronic health records (EHR) that are collected as part of routine clinical care in hospitals worldwide. These rich, longitudinal data offer an attractive object of study for the field of circadian medicine, which aims to translate knowledge of circadian rhythms to improve patient health. This narrative review aims to discuss opportunities for EHR in studies of circadian medicine, highlight the methodological challenges, and provide recommendations for using these data to advance the field. In the existing literature, we find that data collected in real-world clinical settings have the potential to shed light on key questions in circadian medicine, including how 24-hour rhythms in clinical features are associated with—or even predictive of—health outcomes, whether the effect of medication or other clinical activities depend on time of day, and how circadian rhythms in physiology may influence clinical reference ranges or sampling protocols. However, optimal use of EHR to advance circadian medicine requires careful consideration of the limitations and sources of bias that are inherent to these data sources. In particular, time of day influences almost every interaction between a patient and the healthcare system, creating operational 24-hour patterns in the data that have little or nothing to do with biology. Addressing these challenges could help to expand the evidence base for the use of EHR in the field of circadian medicine.

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Section: Opportunities For the Use Of Ehr In Circadian Medicinementioning

confidence: 99%

Using routinely collected clinical data for circadian medicine: A review of opportunities and challenges

Kervezee,

Dashti,

Pilz

et al. 2024

PLOS Digit Health

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Digital healthcare systems in a federated learning perspective

Shafik

2024

Federated Learning for Digital Healthcare Systems

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Chrononutrition in Critical Illness

Sagun,

Akyol,

Kaymak

2024

Nutrition Reviews

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Circadian rhythms in humans are biological rhythms that regulate various physiological processes within a 24-hour time frame. Critical illness can disrupt the circadian rhythm, as can environmental and clinical factors, including altered light exposure, organ replacement therapies, disrupted sleep–wake cycles, noise, continuous enteral feeding, immobility, and therapeutic interventions. Nonpharmacological interventions, controlling the ICU environment, and pharmacological treatments are among the treatment strategies for circadian disruption. Nutrition establishes biological rhythms in metabolically active peripheral tissues and organs through appropriate synchronization with endocrine signals. Therefore, adhering to a feeding schedule based on the biological clock, a concept known as “chrononutrition,” appears to be vitally important for regulating peripheral clocks. Chrononutritional approaches, such as intermittent enteral feeding that includes overnight fasting and consideration of macronutrient composition in enteral solutions, could potentially restore circadian health by resetting peripheral clocks. However, due to the lack of evidence, further studies on the effect of chrononutrition on clinical outcomes in critical illness are needed. The purpose of this review was to discuss the role of chrononutrition in regulating biological rhythms in critical illness, and its impact on clinical outcomes.

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Circadian rhythms of vital signs are associated with in-hospital mortality in critically ill patients: A retrospective observational study

Cited by 3 publications

References 27 publications

Using routinely collected clinical data for circadian medicine: A review of opportunities and challenges

Using routinely collected clinical data for circadian medicine: A review of opportunities and challenges

Digital healthcare systems in a federated learning perspective

Chrononutrition in Critical Illness

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