Ventricular tachycardia and in-hospital mortality in the intensive care unit
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Ventricular tachycardia and in-hospital mortality in the intensive care unit. / Prasad, Priya A.; Isaksen, Jonas L.; Abe-Jones, Yumiko; Zègre-Hemsey, Jessica K.; Sommargren, Claire E.; Al-Zaiti, Salah S.; Carey, Mary G.; Badilini, Fabio; Mortara, David; Kanters, Jørgen K.; Pelter, Michele M.
I: Heart Rhythm O2, Bind 4, Nr. 11, 2023, s. 715-722.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Ventricular tachycardia and in-hospital mortality in the intensive care unit
AU - Prasad, Priya A.
AU - Isaksen, Jonas L.
AU - Abe-Jones, Yumiko
AU - Zègre-Hemsey, Jessica K.
AU - Sommargren, Claire E.
AU - Al-Zaiti, Salah S.
AU - Carey, Mary G.
AU - Badilini, Fabio
AU - Mortara, David
AU - Kanters, Jørgen K.
AU - Pelter, Michele M.
N1 - Publisher Copyright: © 2023 Heart Rhythm Society
PY - 2023
Y1 - 2023
N2 - Background: Continuous electrocardiographic (ECG) monitoring is used to identify ventricular tachycardia (VT), but false alarms occur frequently. Objective: The purpose of this study was to assess the rate of 30-day in-hospital mortality associated with VT alerts generated from bedside ECG monitors to those from a new algorithm among intensive care unit (ICU) patients. Methods: We conducted a retrospective cohort study in consecutive adult ICU patients at an urban academic medical center and compared current bedside monitor VT alerts, VT alerts from a new-unannotated algorithm, and true-annotated VT. We used survival analysis to explore the association between VT alerts and mortality. Results: We included 5679 ICU admissions (mean age 58 ± 17 years; 48% women), 503 (8.9%) experienced 30-day in-hospital mortality. A total of 30.1% had at least 1 current bedside monitor VT alert, 14.3% had a new-unannotated algorithm VT alert, and 11.6% had true-annotated VT. Bedside monitor VT alert was not associated with increased rate of 30-day mortality (adjusted hazard ratio [aHR] 1.06; 95% confidence interval [CI] 0.88–1.27), but there was an association for VT alerts from our new-unannotated algorithm (aHR 1.38; 95% CI 1.12–1.69) and true-annotated VT(aHR 1.39; 95% CI 1.12–1.73). Conclusion: Unannotated and annotated-true VT were associated with increased rate of 30-day in-hospital mortality, whereas current bedside monitor VT was not. Our new algorithm may accurately identify high-risk VT; however, prospective validation is needed.
AB - Background: Continuous electrocardiographic (ECG) monitoring is used to identify ventricular tachycardia (VT), but false alarms occur frequently. Objective: The purpose of this study was to assess the rate of 30-day in-hospital mortality associated with VT alerts generated from bedside ECG monitors to those from a new algorithm among intensive care unit (ICU) patients. Methods: We conducted a retrospective cohort study in consecutive adult ICU patients at an urban academic medical center and compared current bedside monitor VT alerts, VT alerts from a new-unannotated algorithm, and true-annotated VT. We used survival analysis to explore the association between VT alerts and mortality. Results: We included 5679 ICU admissions (mean age 58 ± 17 years; 48% women), 503 (8.9%) experienced 30-day in-hospital mortality. A total of 30.1% had at least 1 current bedside monitor VT alert, 14.3% had a new-unannotated algorithm VT alert, and 11.6% had true-annotated VT. Bedside monitor VT alert was not associated with increased rate of 30-day mortality (adjusted hazard ratio [aHR] 1.06; 95% confidence interval [CI] 0.88–1.27), but there was an association for VT alerts from our new-unannotated algorithm (aHR 1.38; 95% CI 1.12–1.69) and true-annotated VT(aHR 1.39; 95% CI 1.12–1.73). Conclusion: Unannotated and annotated-true VT were associated with increased rate of 30-day in-hospital mortality, whereas current bedside monitor VT was not. Our new algorithm may accurately identify high-risk VT; however, prospective validation is needed.
KW - Alarm fatigue
KW - Algorithm development
KW - Continuous electrocardiographic monitoring
KW - In-hospital mortality
KW - Intensive care unit
KW - Ventricular tachycardia
U2 - 10.1016/j.hroo.2023.09.008
DO - 10.1016/j.hroo.2023.09.008
M3 - Journal article
C2 - 38034889
AN - SCOPUS:85175268093
VL - 4
SP - 715
EP - 722
JO - Heart Rhythm O2
JF - Heart Rhythm O2
SN - 2666-5018
IS - 11
ER -
ID: 374314333