Precocious sepsis detection in critical care patients using heart rate approximate entropy
Sepsis is diagnosed when symptoms and signs are installed. Diagnostic delays cause high morbidity and mortality. Heart rate variability (HRV) has been proposed as a sepsis biomarker. Approximate Entropy (ApEn) is a measure of the complexity of the HRV signal. Objective: To determin...
| Autores principales: | , , |
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2023
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| Materias: | |
| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/42828 |
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I10-R327-article-42828 |
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Universidad Nacional de Córdoba |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
infection Emergency heart rate entropy sepsis infección Emergencia frecuencia cardiaca entropía sepsis . |
| spellingShingle |
infection Emergency heart rate entropy sepsis infección Emergencia frecuencia cardiaca entropía sepsis . Díaz , A Tolosa, M Cuestas, E Precocious sepsis detection in critical care patients using heart rate approximate entropy |
| topic_facet |
infection Emergency heart rate entropy sepsis infección Emergencia frecuencia cardiaca entropía sepsis . |
| author |
Díaz , A Tolosa, M Cuestas, E |
| author_facet |
Díaz , A Tolosa, M Cuestas, E |
| author_sort |
Díaz , A |
| title |
Precocious sepsis detection in critical care patients using heart rate approximate entropy |
| title_short |
Precocious sepsis detection in critical care patients using heart rate approximate entropy |
| title_full |
Precocious sepsis detection in critical care patients using heart rate approximate entropy |
| title_fullStr |
Precocious sepsis detection in critical care patients using heart rate approximate entropy |
| title_full_unstemmed |
Precocious sepsis detection in critical care patients using heart rate approximate entropy |
| title_sort |
precocious sepsis detection in critical care patients using heart rate approximate entropy |
| description |
Sepsis is diagnosed when symptoms and signs are installed. Diagnostic delays cause high morbidity and mortality. Heart rate variability (HRV) has been proposed as a sepsis biomarker. Approximate Entropy (ApEn) is a measure of the complexity of the HRV signal. Objective: To determine heart rate ApEn value for precocious sepsis detection.
A prospective observational study was carried out at Hospital Misericordia, between 2016 - 2018. Both gender patients >15 years old admitted to ICU were included. Patients with disorder that could alter HRV (cardiopulmonary, neurological, arrhythmias, beta-blockers, or calcium blockers) were excluded. Study variable: blood culture confirmed sepsis. Main predictor: hearth rate (HR) ApEn. HR was determined by pulse and continuous ECG monitoring. Covariates: age, sex, APACHEII, Glasgow and SOFA scores, morbidity, admission diagnosis, complications, and mortality. Discrete variables were described in absolute and relative frequencies with 95%CI. Normal continuous variables in means ± SD and non-normal variables in medians and interquartile ranges. Bivariate analysis was performed using Fischer test, t test or Mann-Whitney U test. Multivariate analysis was carried out in a multiple logistic regression model. HR ApEn cut-off point was determined by the area under ROC curve. Significant p value was established < 0.05.
153 patients were studied. Mean age 42.5 ± 25 years. 86 males (56.2%). Sepsis was confirmed in 85 (55.5%). The overall median HR ApEn was 0.352. ApEn in septic patients was 0.414 vs 0.076 in non-septic patients, p < 0.001. ApEn cut-off point was 0.244 with a sensitivity of 97.7%, specificity of 90.6%, positive predictive value of 94.4% and a negative predictive value of 96.0%.
HR ApEn values greater than 0.244 predicts confirmed bacterial sepsis 24 hours before clinical presentation´s signs. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2023 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/42828 |
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I10-R327-article-428282023-10-19T21:18:59Z Precocious sepsis detection in critical care patients using heart rate approximate entropy Entropía aproximada de la frecuencia cardíaca para el diagnóstico precoz de sepsis en adultos internados en terapia intensiva . Díaz , A Tolosa, M Cuestas, E infection Emergency heart rate entropy sepsis infección Emergencia frecuencia cardiaca entropía sepsis . Sepsis is diagnosed when symptoms and signs are installed. Diagnostic delays cause high morbidity and mortality. Heart rate variability (HRV) has been proposed as a sepsis biomarker. Approximate Entropy (ApEn) is a measure of the complexity of the HRV signal. Objective: To determine heart rate ApEn value for precocious sepsis detection. A prospective observational study was carried out at Hospital Misericordia, between 2016 - 2018. Both gender patients >15 years old admitted to ICU were included. Patients with disorder that could alter HRV (cardiopulmonary, neurological, arrhythmias, beta-blockers, or calcium blockers) were excluded. Study variable: blood culture confirmed sepsis. Main predictor: hearth rate (HR) ApEn. HR was determined by pulse and continuous ECG monitoring. Covariates: age, sex, APACHEII, Glasgow and SOFA scores, morbidity, admission diagnosis, complications, and mortality. Discrete variables were described in absolute and relative frequencies with 95%CI. Normal continuous variables in means ± SD and non-normal variables in medians and interquartile ranges. Bivariate analysis was performed using Fischer test, t test or Mann-Whitney U test. Multivariate analysis was carried out in a multiple logistic regression model. HR ApEn cut-off point was determined by the area under ROC curve. Significant p value was established < 0.05. 153 patients were studied. Mean age 42.5 ± 25 years. 86 males (56.2%). Sepsis was confirmed in 85 (55.5%). The overall median HR ApEn was 0.352. ApEn in septic patients was 0.414 vs 0.076 in non-septic patients, p < 0.001. ApEn cut-off point was 0.244 with a sensitivity of 97.7%, specificity of 90.6%, positive predictive value of 94.4% and a negative predictive value of 96.0%. HR ApEn values greater than 0.244 predicts confirmed bacterial sepsis 24 hours before clinical presentation´s signs. La sepsis es un síndrome que solo puede diagnosticarse cuando los síntomas y signos están instalados implicando una elevada morbimortalidad por la demora diagnóstica. La variabilidad de la frecuencia cardíaca (VFC) se ha propuesto como biomarcador para la sepsis. La Entropía Aproximada (EnAp) es una medida de la complejidad de la señal de VFC. Objetivo: Determinar el valor de EnAp de la frecuencia cardíaca (FC) para el diagnóstico precoz de sepsis. Se realizó un estudio observacional prospectivo en el Hospital Misericordia, entre agosto de 2016 y marzo de 2018. Incluyó pacientes de ambos sexos >15 años internados en UTI. Se excluyó pacientes con enfermedad que pudiera alterar la VFC (cardiopulmonar, neurológica, arritmias, uso de betabloqueantes o bloqueantes cálcicos). Variable de estudio: sepsis confirmada por hemocultivo. Variables predictoras principales: EnAp de la FC. La FC se determinó por monitoreo continuo, manual y electrocardiográfico. Covariables: edad, sexo, scores APACHEII, Glasgow y SOFA, morbilidad, diagnóstico de ingreso, complicaciones y mortalidad. Las variables continuas se describieron en frecuencias absolutas y relativas con IC95%. Las continuas normales en medias ± DE y las no normales en medianas e intervalos intercuartílicos. Análisis bivariado mediante prueba de Fischer, test de t o U de Mann-Whitney. Análisis multivariado en un modelo de regresión logística múltiple. El punto de corte de la EnAp de la FC se determinó por el área bajo la curva ROC. Valor de significación p < 0,05. Se estudiaron 153 pacientes. Edad promedio 42,5 años + 25. Varones 86 (56,2%). Sepsis confirmada en 85 (55,5%). La mediana general de la EnAp de la FC fue de 0,352. EnAp en sépticos 0,414 vs no sépticos 0,076 p < 0,001. Punto de corte de EnAp en curva ROC de 0,244 con sensibilidad 97,7%, especificidad de 90,6%, un valor predictivo positivo de 94,4% y un valor predictivo negativo de 96,0%. Un valor de EnAp de la FC mayor de 0,244 predice la presencia de sepsis bacteriana confirmada con 24 hs de antelación a la presentación de los síntomas y los signos. . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-10-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/42828 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 (2023): Suplemento JIC XXIV Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 (2023): Suplemento JIC XXIV Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 (2023): Suplemento JIC XXIV 1853-0605 0014-6722 spa https://revistas.unc.edu.ar/index.php/med/article/view/42828/42843 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |