The Impact of Heart Rate Circadian Rhythm on In-hospital Mortality in Stroke and Critically Ill Patients: Insights from the eICU Collaborative Research Database

作者：Zhengning Yang, Zhe Li, Xu He, Zhen Yao, Xiaoxia Xie, Sha Zhang, Yan Shen, Shaowei Li, Shuzhen Qiao, Zhenliang Hui, Chao Gao, Jun Chen · 发表于：Research Square · 年份：2022 · DOI：10.21203/rs.3.rs-1218231/v1 · 研究领域：Blood Pressure and Hypertension Studies、Climate Change and Health Impacts、Hemodynamic Monitoring and Therapy

Abstract Background: The dysregulation of the heart rate circadian rhythm has been documented to be an independent risk factor in multiple diseases. However, data showing the impact of dysregulated heart rate circadian rhythm in stroke and critically ill patients are scarce. Methods: Stroke and critically ill patients in the ICU between 2014 and 2015 from the recorded eICU Collaborative Research Database were included in the current analyses. The impact of circadian rhythm of heart rate on in-hospital mortality was analyzed. Three variables, Mesor (rhythm-adjusted mean of heart rate), Amplitude (distance from the highest point of circadian rhythm of heart rate to Mesor), and Peak time (time when the circadian rhythm of heart rate reaches the highest point) were used to evaluate the heart rate circadian rhythm. The incremental value of circadian rhythm variables in addition to Acute Physiology and Chronic Health Evaluation (APACHE) IV score to predict in-hospital mortality was also explored. Results: A total of 6,201 eligible patients were included. The in-hospital mortality was 16.2% (1,002/6,201). The circadian rhythm variables of heart rate, Mesor, Amplitude, and Peak time, were identified to be independent risk factors of in-hospital mortality. After adjustments, Mesor per 10 beats per min (bpm) increase was associated with a 1.17-fold (95%CI: 1.11, 1.24, P<0.001) and Amplitude per 5 bpm was associated with a 1.14-fold (95%CI: 1.06, 1.24, P<0.001) increase in the ris...