Prehospital Loss of R-to-R Interval Complexity is Associated With Mortality in Trauma Patients

• DOI: 10.1097/ta.0b013e318142d2f0
• Publication Date: 2007-09-12T07:01:40Z
• Authors: Andriy I. Batchinsky; Leopoldo C. Cancio; Jose Salinas; Tom Kuusela; William H. Cooke; Jing Jing Wang; Marla Boehme; Victor A. Convertino; John B. Holcomb
• Keywords: Approximate entropy; Sample entropy

Background: To improve our ability to identify physiologic deterioration caused by critical injury, we applied nonlinear analysis the R-to-R interval (RRI) of electrocardiogram prehospital trauma patients. Methods: Ectopy-free, 800-beat sections from 31 patients were identified. Twenty survived (S) and 11 died (NonS) after hospital admission. Demographic data, heart rate, blood pressure, field Glasgow Coma Scale (GCS) score, survival times recorded. RRI complexity was assessed via statistics, which quantify entropy or fractal properties. Results: Age rate pressure not different between groups. Mean time 129 hours ± 62 hours. NonS had a lower GCS score (8.6 1.7 vs. 13.2 0.8, p < 0.05). approximate (ApEn; 0.87 0.06 1.09 0.07, 0.01), sample (SampEn; 0.80 0.08 1.10 0.05, 0.01) dimension dispersion (1.08 0.02 1.13 0.01, 0.05) in NonS. Distribution symbol 2 (Dis_2), symbol-dynamics measure distribution, higher (292.6 34.4 222 21.3, 0.10). For logistic regression revealed ApEn Dis_2 as independent predictors mortality (area under receiver-operating characteristic curve = 0.96). When GCSMOTOR considered, it replaced whereas retained 0.92). Injury Severity Score GCSMOTOR; retained. Conclusions: Prehospital loss complexity, evidenced decreased entropy, associated with Score.