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Complex dynamics of skin sympathetic nerve activities as a prognostic predictor for critically ill patients
- Source :
- Journal of the Formosan Medical Association, Vol 120, Iss 1, Pp 660-667 (2021)
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background The skin sympathetic nerve activity (SKNA) is a new method to measure sympathetic nerve activity by using conventional ECG electrodes. We developed a novel approach to analyze the complexity of SKNA time series under different time scales and showed its prognostic significance in patients receiving critical care. Methods This study measured SKNA in patients admitted to an intensive care unit (ICU). Each recording is 10-minute long with 10000Hz sampling rate. Multi-scale fluctuation analysis (MSFA) was developed to quantify the variation within each time scale after removing the linear trend. The prognostic value of SKNA was combined with traditional prognostics scoring system to improve the predictive values. Results 155 patients were recruited. After 30 and 90 days, 30 and 48 patients expired. MSFA was significantly higher in survival group than mortality group for 30-day (0.487 ± 0.185 vs 0.401 ± 0.045, p = 0.018) and 90-day (0.499 ± 0.196 vs 0.414 ± 0.061, p = 0.001) follow-up. Sequential Organ Failure Assessment (SOFA) score was significantly lower in the survival group compared to the expired group for 30-day and 90-day (4.1 ± 2.9 vs. 5.5 ± 4.1, p = 0.032 and 3.9 ± 3.0 vs. 5.4 ± 3.5, p = 0.012). The Kaplan–Meier survival analysis showed MSFA lower than 0.401 (log-rank test:4.96, p = 0.03) or with SOFA score lower than 5 (log-rank test:5.49, p = 0.019) have a significantly higher mortality rate. A multivariate Cox regression model showed that the MSFA is an independent predictor for 30-day mortality (HR = 2.35, 1.08–5.09, p = 0.031) and 90-day mortality (HR = 1.96, 1.08–3.58, p = 0.027). Conclusion MSFA was a significant prognostic predictor for critically ill patients. MSFA adding to SOFA score could help improve risk prediction.
- Subjects :
- medicine.medical_specialty
Multivariate statistics
law.invention
03 medical and health sciences
0302 clinical medicine
law
Internal medicine
Medicine
Heart rate variability
Critical care medicine
Survival analysis
lcsh:R5-920
Proportional hazards model
business.industry
Critically ill
Mortality rate
General Medicine
Skin sympathetic nerve activity
Intensive care unit
030220 oncology & carcinogenesis
Cardiology
030211 gastroenterology & hepatology
SOFA score
lcsh:Medicine (General)
business
Multi-scale fluctuation analysis
Subjects
Details
- ISSN :
- 09296646
- Volume :
- 120
- Database :
- OpenAIRE
- Journal :
- Journal of the Formosan Medical Association
- Accession number :
- edsair.doi.dedup.....92ded8f7b27e3062d6736a75cb98dddd