Acute cardiac care & resuscitationCohort study
Pressure-Adjusted Heart Rate by Echocardiography and Mortality in the Cardiac Intensive Care Unit
- retrospective cohort
- academic cardiac intensive care unit (CICU) (2007-2018)
Authors' conclusion
PAHR is a readily determinable composite measure of cardiovascular status that enhances clinical risk stratification of critically ill patients, performing better than MAP, HR, and Modified Shock Index. Among CICU patients, higher PAHR by TTE was associated with greater mortality.
Study context
- Population
- Patients with a transthoracic echocardiogram (TTE) within 24 hours of admission to an academic CICU
- Participants
- 5,411 patients
- Exposure
- Per 1 BPM higher PAHR obtained from TTE
- Outcome
- In-hospital mortality
Main finding
As reported in the abstract
Adjusted odds ratio
1.03
95% CI 1.01–1.05
P = 0.001
each 1 BPM higher PAHR
adjusted OR 1.03 (95% CI 1.01–1.05); P = 0.001
Each 1 BPM higher PAHR, as printed
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Values | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|
| One-year mortality (secondary outcome) · mortality increased with higher PAHR | 1.03 (1.02–1.04) | P < 0.001 | ||
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Median PAHR by in-hospital death | patients who died while hospitalized median 14.3 beats/min · survivors median 6.8 BPM |
- Median PAHR by in-hospital death: P < 0.001
Discrimination of PAHR for in-hospital mortality
- C-statistic
- 0.75
- moderate discrimination
Original publication
Pressure-Adjusted Heart Rate by Echocardiography and Mortality in the Cardiac Intensive Care Unit. JACC Adv. Published 13 June 2026. doi:10.1016/j.jacadv.2026.102887
Summarised from the published abstract; every number is checked against it