J Korean Med Sci.  2010 Aug;25(8):1140-1145. 10.3346/jkms.2010.25.8.1140.

Heart Rate Variability and Length of Survival in Hospice Cancer Patients

• Kim DH
• Kim JA
• Choi YS
• Kim SH
• Lee JY
• Kim YE

• KMID: 1714033
• DOI: http://doi.org/10.3346/jkms.2010.25.8.1140

Abstract

We examined the association between heart rate variability (HRV) and survival duration to evaluate the usefulness of HRV as a prognostic factor for hospice cancer patients. In terminally ill cancer patients who visited the Hospice clinic, we checked demographic data, Karnofsky performance scale (KPS), HRV, dyspnea, anorexia, as well as fasting blood glucose and total cholesterol. After following up their duration of survival, we examined meaningful prognostic factors for predicting life expectancy through the survival analysis. A total of 68 patients were included in final analysis. As KPS was lower, or when combined with dyspnea or anorexia, the survival duration was much shorter. HRV parameters except heart rate were all impaired in most patients. In particular, the group with mean heart rate of 100 or more beats per minute and the group with standard deviations of normal-to-normal R-R intervals (SDNN) of 21.3 ms (75 percentile) or less showed significantly shorter survival duration. The final multivariate analysis adjusting for age, gender, fasting blood glucose, and total cholesterol showed that KPS, dyspnea, anorexia, and SDNN were significant prognostic factors in survival duration. For the first time, we report that SDNN is a prognostic factor in terminal cancer patients.

Keyword

Terminal Care; Life Expectancy; Prognosis; Heart Rate Variability

MeSH Terms

Adult
Aged
Aged, 80 and over
Female
Heart Rate/*physiology
Hospices
Humans
Male
Middle Aged
Multivariate Analysis
Neoplasms/*mortality
Prognosis
Survival Analysis
Terminal Care

Figure

• 

  Fig. 1 Kaplan-Meier survival curves (n=68). (A) Karnofsky performance status scale* (P<0.001). (B) Anorexia (P=0.015). (C) Dyspnea (P=0.037). (D) Mean heart rate (dichotomized by 100 bpm). (E) SDNN (dichotomized by quartile 3, 21.3 msec). *KPS variable was grouped according to the reference level of palliative prognostic score.

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