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Relationship between minimum heart rate and mortality in ICU patients with traumatic brain injury (TBI): a
Xin Li1, Meng Han1, Xiaoliang Wang1
1Neurology Department of Qingdao Municipal Hospital, Qingdao, Shandong Province, China.
Background:
The association between minimum heart rate (MinHR) within 24 h of ICU admission and 1-month mortality in traumatic brain injury (TBI) patients remains unclear.
Methods:
This retrospective cohort study analyzed 2267 TBI patients from the MIMIC-IV v3.1 database. Multivariable Cox regression, restricted cubic spline (RCS) analysis, and subgroup analyses evaluated relationships between 24-hour MinHR and mortality.
Results:
The cohort (median age 67 [IQR 51-80] years; 62.6% female) had a median MinHR of 59 [52-68] bpm, with 248 deaths (10.94%). RCS analysis revealed a U-shaped association (P for nonlinear =0.001) with 59 bpm as the inflection point. MinHR ≥59 bpm independently predicted higher mortality after full adjustment (HR=1.84, 95%CI:1.31-2.60; P < 0.001). This association was pronounced in non-hypertensive patients (HR=1.50, 95%CI:1.08-2.08; P = 0.015).
Conclusions:
A U-shaped association exists between 24-hour MinHR and 1-month mortality in TBI patients, with 59 bpm as the critical threshold. MinHR ≥59 bpm independently predicts increased mortality. These findings support using 59 bpm as an alert threshold for early intervention.
