Significance of new-onset prolonged sinus tachycardia in a medical intensive care unit: a prospective observational study

J Crit Care. 2011 Oct;26(5):534.e1-534.e8. doi: 10.1016/j.jcrc.2011.01.001. Epub 2011 Mar 3.

Abstract

Objective: Few data are available on sinus tachycardia among medical intensive care unit (ICU) patients. We investigated new critical illnesses related to new-onset prolonged sinus tachycardia (NOPST) and the relationship of NOPST with ICU mortality.

Methods: The heart rate (HR) of all enrolled patients was monitored hourly over a 12-month period, and NOPST was defined as sinus tachycardia (>100 beats/min) with an increase in HR of more than 20% from the baseline value lasting longer than 6 hours.

Results: Among the 522 patients enrolled, the average mean HR was 96.1 ± 18.4 beats/min. Fifty-two (10.0%) patients met the criteria for NOPST; pneumonia, delirium, septic shock, acute respiratory distress syndrome, catheter-related infections, and mechanical ventilator-related problems were related to the occurrence of NOPST. The ICU mortality rate in patients with a NOPST duration of more than 72 hours was higher compared with other patients with NOPST (60.0% vs 18.5%; P = .002). A high daily mean HR rather than NOPST was a significant predictor of ICU mortality (odds ratio, 1.415; 95% confidence interval, 1.177-1.700).

Conclusions: Although NOPST was not associated with ICU mortality, it indicates the presence of new critical events in the medical ICU setting.

MeSH terms

  • Aged
  • Heart Conduction System / physiopathology*
  • Heart Rate / physiology
  • Hospital Mortality*
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Prospective Studies
  • Tachycardia, Sinus / mortality*
  • Tachycardia, Sinus / physiopathology
  • Tachycardia, Sinus / therapy
  • Treatment Outcome