Tachycardia is considered a physiologic response to traumatic hypotension.
The inability of the heart to respond to shock with tachycardia has been described as paradoxical bradycardia or relative bradycardia.
The incidence and clinical significance of this condition in major trauma is not known.
The objective of this study was to examine the incidence and prognostic significance of tachycardia and relative bradycardia in patients with traumatic hypotension.
Relative bradycardia is defined as a systolic pressure <=90 mm Hg and a pulse rate <=90 beats per minute.
This is a retrospective study conducted at a large Level I academic trauma center during a 4-year period.
Seventeen demographic and injury severity factors were analyzed for their possible role in tachycardic or bradycardic response in hypotensive patients.
Incidence and mortality were derived for each subpopulation.
Bivariate analysis of the association of incidence and mortality with each risk factor was performed.
Factors with p values<0.2 were included in stepwise logistic regression analyses that identified significant risk factors and derived adjusted relative mortality risks between tachycardic and bradycardic hypotensive patients.
Excluding transfers and patients dead on arrival, 10,833 major trauma patients were seen during the study period.
Seven hundred fifty patients (6.9%) had systolic blood pressure <= 90 mm Hg ; 533 patients had tachycardia (overall incidence of 4. (...)
Mots-clés Pascal : Choc, Association, Traumatisme, Hémorragie, Hémodynamique, Symptomatologie, Hypotension artérielle, Facteur prédictif, Pronostic, Bradycardie, Incidence, Mortalité, Epidémiologie, Homme, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Cardiopathie, Trouble rythme cardiaque, Bradycardie paradoxale
Mots-clés Pascal anglais : Shock, Association, Trauma, Hemorrhage, Hemodynamics, Symptomatology, Arterial hypotension, Predictive factor, Prognosis, Bradycardia, Incidence, Mortality, Epidemiology, Human, Cardiovascular disease, Vascular disease, Heart disease, Arrhythmia
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0483559
Code Inist : 002B27B01. Création : 19/02/1999.