Predicting 7-Day Survival Using Heart Rate Variability in Hospice Patients with Non-Lung Cancers

Jui Kun Chiang, Terry B J Kuo, Chin Hua Fu, Malcolm Koo

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background:A simple and accurate survival prediction tool can facilitate decision making processes for hospice patients with advanced cancers. The objectives of this study were to explore the association of cardiac autonomic functions and survival in patients with advanced cancer and to evaluate the prognostic value of heart rate variability (HRV) in 7-day survival prediction.Methods:A prospective study was conducted on 138 patients with advanced cancer recruited from the hospice ward of a regional hospital in southern Taiwan. Information on functional status and symptom burden of the patients was recorded. Frequency-domain HRV was obtained for the evaluation of cardiac autonomic functions at admission. The end point of the study was defined as the survival status at day 7 after admission to the hospice ward. Multivariate logistic regression analyses were performed to evaluate the independent associations between HRV indices and survival of 7 days or less.Results:The median survival time of the patients was 20 days (95% CI, 17-28 days). Results from the multivariate logistic regression analysis indicated that the natural logarithm-transformed high-frequency power (lnHFP) of a value less than 2 (OR = 3.8, p = 0.008) and ECOG performance status of 3 or 4 (OR = 3.4, p = 0.023) were significantly associated with a higher risk of survival of 7 days or less. Receiver operating characteristic (ROC) curve analysis revealed that the area under the curve was 0.71 (95% CI, 0.61-0.81).Conclusions:In hospice patients with non-lung cancers, an lnHPF value below 2 at hospice admission was significantly associated with survival of 7 days or less. HRV might be used as a non-invasive and objective tool to facilitate medical decision making by improving the accuracy in survival prediction.

Original languageEnglish
Article numbere69482
JournalPLoS One
Volume8
Issue number7
DOIs
Publication statusPublished - Jul 23 2013
Externally publishedYes

Fingerprint

Hospices
heart rate
Heart Rate
neoplasms
Survival
Logistics
Neoplasms
Decision making
prediction
decision making
Regression analysis
functional status
Logistic Models
prospective studies
Regression Analysis
signs and symptoms (animals and humans)
Taiwan
regression analysis
ROC Curve
Area Under Curve

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Predicting 7-Day Survival Using Heart Rate Variability in Hospice Patients with Non-Lung Cancers. / Chiang, Jui Kun; Kuo, Terry B J; Fu, Chin Hua; Koo, Malcolm.

In: PLoS One, Vol. 8, No. 7, e69482, 23.07.2013.

Research output: Contribution to journalArticle

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