The impact of heart rate circadian rhythm on in-hospital mortality in patients with stroke and critically ill: Insights from the eICU Collaborative Research Database

Yang, Zhengning; Li, Zhe; He, Xu; Yao, Zehan; Xie, Xiaoqing; Zhang, Sha; Shen, Yan; Li, Shaowei; Qiao, Shuzhen; Hui, Zhenliang; Gao, Chao

doi:10.1016/j.hrthm.2022.03.1230

Cited by 13 publications

(11 citation statements)

References 37 publications

(29 reference statements)

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“…Vascular events in previous reports which show an excess of death between 06:00 and noon are in line with our in‐hospital mortality pattern, indicating the possible existence of similar underlying mechanism related to in‐hospital mortality, although the physiological mechanism of circadian variation is not well understood and remains speculative. Those events include myocardial angina, acute myocardial infarction, cardiac arrest, arrhythmias (de Rueda et al, 2022 ; Muller et al, 1989 ; Xin et al, 2022 ), deep venous thrombosis, pulmonary thromboembolism (Bilora et al, 2001 ; Colantonio et al, 1989 ; Damnjanović, 2018 ; Gallerani et al, 1994 ), and stroke (ischemic and haemorrhagic strokes and transient ischemic attacks) (Argentino et al, 1990 ; Elliott, 1998 ; Yang et al, 2022 ). The implication for nursing care is that strengthening monitor for patients with those disorders at certain time may be needed.…”

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Circadian aspects of mortality in hospitalized patients: A retrospective observation from a large cohort

et al. 2023

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Accumulating evidence has indicated the importance of circadian variations on regulating body functions (e.g., sleep-wake cycle, hormone secretion, blood and temperature regulation, and autonomic nervous tone; Baschieri & Cortelli, 2019;Crnko et al., 2019;Kvaslerud et al., 2010) which plays a great role on disease development. In clinical observation, many cardiovascular diseases (e.g., myocardial infarction, stroke, and arrhythmia) have shown to be closely associated with circadian rhythms (Aronow & Ahn, 2003;Yang et al., 2022). With regard to endogenous rhythms in relation to mortality, sudden cardiac death (SCD) has been mostly studied.Those studies demonstrated that the occurrence of death increases at certain times of the day (Chen & Yang, 2015;Delisle et al., 2021). However, to date, endogenous patterns in relation to mortality of other diseases have rarely been investigated. Whether there is a circadian distribution in overall mortality has yet to be determined.In clinical practice, nurse is the front line of monitoring and treatment for patients, especially for those in intensive care unit (ICU).One study pointed out the importance of research on circadian rhythm and formulated the nursing protocol of identifying circadian health disorders in ICU and hospitalized patients (Padilla-Martínez

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Circadian aspects of mortality in hospitalized patients: A retrospective observation from a large cohort

et al. 2023

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“…(2.0-172.0×10 9 /L), Q2 (173.0-215.0×10 9 /L), Q3 (216.0-264.0×10 9 /L), and Q4 (265.0-487.0×10 9 /L). The covariates were selected based on clinical experience and previous studies (18)(19)(20)(21). The included variables were: (1)…”

Section: Variablesmentioning

confidence: 99%

Nonlinear relationship between platelet count and 30-day in-hospital mortality in ICU stroke patients: a multicenter retrospective cohort study

Wang,

Liu,

Zhou

et al. 2024

Preprint

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Background: Evidence of the relationship between platelet count and 30-day in-hospital mortality in ICU stroke patients is still scarce. Therefore, the purpose of this study was to explore the relationship between platelet count and 30-day in-hospital mortality among ICU stroke patients. Methods: We conducted a multicenter retrospective cohort study using data from 8029 ICU stroke patients in the US eICU-CRD v2.0 database from 2014 to 2015. Utilizing binary logistic regression, smooth curve fitting, and subgroup analyses, we examined the link between platelet count and 30-day in-hospital mortality. Results: The 30-day in-hospital mortality prevalence was 14.02%, and the mean platelet count of 223×109/L. Adjusting for covariates, our findings revealed an inverse association between platelet count and 30-day in-hospital mortality (OR = 0.975, 95% CI: 0.966, 0.984). Subgroup analyses supported the robustness of these results. Moreover, a nonlinear relationship was observed between platelet count and 30-day in-hospital mortality, with the inflection point at 163×109/L. On the left side of the inflection point, the effect size (OR) was 0.92 (0.89, 0.95), while on the right side, the relationship was not statistically significant. Conclusion: This study establishes an independent negative association between platelet count and 30-day in-hospital mortality in ICU stroke patients. Furthermore, a nonlinear relationship with a saturation effect was identified, suggesting that maintaining the platelet count around 163×109/L can reduce 30-day in-hospital mortality in these patients.

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“…The covariates were chosen based on clinical experience and prior studies [18][19][20][21]. Included variables comprised: (1) categorical variables-sex, ethnicity, acute respiratory failure (ARF), atrial brillation (AF), acute coronary syndrome (ACS), congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes mellitus, gastrointestinal bleeding (GB), hypertension, sepsis, use of anti-platelet medications, anticoagulants, glucocorticoids, carbapenems, cephalosporins, vancomycin, and mechanical ventilation; (2) continuous variables-age, hemoglobin concentration (Hb), blood urea nitrogen (BUN), serum creatinine (Scr), albumin (ALB), and Acute Physiology and Chronic Health Evaluation-IV score (APACHE-IV score).…”

Section: Covariatesmentioning

confidence: 99%

Platelet count has a nonlinear association with 30-day in-hospital mortality in ICU End- stage kidney disease patients: a multicenter retrospective cohort study

Zhou,

Xiao,

et al. 2024

Preprint

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Background: This study addresses the relationship between platelet count and 30-day in-hospital mortality in End-Stage Kidney Disease (ESRD) patients in the intensive care unit (ICU), a topic with limited existing evidence. Methods: Utilizing data from the US eICU-CRD v2.0 database (2014-2015), a retrospective cohort study was conducted involving 3700 ICU ESRD patients. We employed binary logistic regression, smooth curve fitting, and subgroup analyses to explore the association between platelet count and 30-day in-hospital mortality. Results: The 30-day in-hospital mortality rate was 13.27% (491/3700), with a median platelet count of 188×109/L. After adjusting for covariates, we observed an inverse relationship between platelet count and 30-day in-hospital mortality (OR = 0.98, 95% CI: 0.97, 0.99). Subgroup analyses supported these findings, particularly in non-diabetic patients (P for interaction 0.0002). Additionally, a nonlinear association surfaced, revealing an inflection point at 222×109/L. The effect sizes (OR) on the left and right sides of the inflection point were 0.94 (0.92, 0.96) and 1.03 (1.00, 1.05), respectively. Conclusion: This study identified a curved relationship between platelet count and 30-day in-hospital mortality rate in ICU ESRD patients. The saturation effect suggests that maintaining a platelet count around 222×109/L can reduce the in-hospital mortality rate of these patients for 30 days.

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The impact of heart rate circadian rhythm on in-hospital mortality in patients with stroke and critically ill: Insights from the eICU Collaborative Research Database

Cited by 13 publications

References 37 publications

Circadian aspects of mortality in hospitalized patients: A retrospective observation from a large cohort

Circadian aspects of mortality in hospitalized patients: A retrospective observation from a large cohort

Nonlinear relationship between platelet count and 30-day in-hospital mortality in ICU stroke patients: a multicenter retrospective cohort study

Platelet count has a nonlinear association with 30-day in-hospital mortality in ICU End- stage kidney disease patients: a multicenter retrospective cohort study

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