Zhaolin Zhang, Hanlin Huang, Pengyi Pan, L N Zhang, Chen Zhang, Guoyu Lu
Objective To explore the application value of heart rate variability (HRV) combined with SOFA score and APACHE II score in predicting the 28-day mortality risk of patients in the emergency intensive care unit (EICU), and to provide a basis for early clinical risk assessment.
Objective To explore the application value of heart rate variability (HRV) combined with SOFA score and APACHE II score in predicting the 28-day mortality risk of patients in the emergency intensive care unit (EICU), and to provide a basis for early clinical risk assessment. Method A retrospective study was conducted on 115 patients admitted to the EICU of the First Affiliated Hospital of Bengbu Medical University. The patients were divided into the survival group ( n = 75) and the death group ( n = 40) based on their 28-day survival outcome. Demographic data, SOFA score, APACHE II score, and HRV-related indicators were collected. Univariate analysis, multivariate Logistic regression, Spearman correlation analysis, and receiver operating characteristic curve (ROC) analysis were used to evaluate the distribution characteristics and predictive efficacy of each indicator. Result Compared with the survival group, the death group had significantly higher age, SOFA score, and APACHE II score ( p < 0.05), and significantly lower HRV indicators such as PNS index and Mean RR ( p < 0.01). Spearman analysis showed that SOFA score ( r = 0.378) and APACHE II score ( r = 0.456) were significantly positively correlated with death, while PNS index ( r = −0.278) and Mean RR ( r = −0.299) were negatively correlated with death (all p < 0.01). In the multivariate regression, only SDHR was an independent risk factor (OR = 3.211, p = 0.041). ROC curve analysis showed that the AUCs of HRV, SOFA score, and APACHE II score for predicting death were 0.737, 0.728, and 0.776, respectively. The AUC was 0.831 when the three were combined, indicating a significant improvement in predictive performance. Conclusion Heart rate variability parameters can reflect the autonomic nerve function status of EICU patients. The combination of HRV with the SOFA score and APACHE II score system can improve the accuracy of predicting the 28-day mortality risk of EICU patients.