Heart Rate Variability as a Predictor of Death in Burn Patients

Area of Science:

• Cardiology
• Trauma Medicine
• Physiology

Background:

• Heart rate variability (HRV) quantifies normal heart beat (NN) interval fluctuations and predicts mortality in certain patient groups.
• Burn trauma significantly impacts physiological parameters, necessitating reliable prognostic indicators.

Purpose of the Study:

• To evaluate the predictive value of HRV for mortality in burn trauma patients.
• To investigate the correlation between HRV parameters and burn severity (%TBSA).

Main Methods:

• Prospective 24-hour Holter monitoring in burn patients.
• Analysis of time and frequency domain HRV parameters.
• Correlation analysis between HRV, %TBSA, and mortality outcomes.

Main Results:

• Higher %TBSA burn was observed in non-survivors compared to survivors (55% vs 19%, P < .0001).
• Significant inverse correlations were found between %TBSA and SD of NN intervals (r = -0.337, P = .034) and ultra low frequency power (r = -0.351, P = .027).
• Receiver-operator characteristic analysis demonstrated high predictive accuracy for %TBSA (AUC=0.82), SDANN (AUC=0.94), and ultra low frequency power (AUC=0.96) for mortality.

Conclusions:

• Deranged HRV in the early postburn period is a potent predictor of mortality.
• HRV parameters, particularly SDANN and ultra low frequency power, show strong potential for predicting death in burn patients.
• HRV assessment offers a valuable, noninvasive tool for risk stratification in burn trauma care.