Multi-scale symbolic entropy analysis provides prognostic prediction in patients receiving extracorporeal life support

Yen Hung Lin; Hui Chun Huang; Yi Chung Chang; Chen Lin; Men Tzung Lo; Li Yu Daisy Liu; Pi Ru Tsai; Yih Sharng Chen; Wen Je Ko; Yi Lwun Ho; Ming Fong Chen; Chung Kang Peng; Timothy G. Buchman

doi:10.1186/s13054-014-0548-3

Multi-scale symbolic entropy analysis provides prognostic prediction in patients receiving extracorporeal life support

Yen Hung Lin, Hui Chun Huang, Yi Chung Chang, Chen Lin, Men Tzung Lo, Li Yu Daisy Liu, Pi Ru Tsai, Yih Sharng Chen, Wen Je Ko, Yi Lwun Ho, Ming Fong Chen, Chung Kang Peng, Timothy G. Buchman

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31 Scopus citations

Abstract

Introduction: Extracorporeal life support (ECLS) can temporarily support cardiopulmonary function, and is occasionally used in resuscitation. Multi-scale entropy (MSE) derived from heart rate variability (HRV) is a powerful tool in outcome prediction of patients with cardiovascular diseases. Multi-scale symbolic entropy analysis (MSsE), a new method derived from MSE, mitigates the effect of arrhythmia on analysis. The objective is to evaluate the prognostic value of MSsE in patients receiving ECLS. The primary outcome is death or urgent transplantation during the index admission. Methods: Fifty-seven patients receiving ECLS less than 24 hours and 23 control subjects were enrolled. Digital 24-hour Holter electrocardiograms were recorded and three MSsE parameters (slope 5, Area 6-20, Area 6-40) associated with the multiscale correlation and complexity of heart beat fluctuation were calculated. Results: Patients receiving ECLS had significantly lower value of slope 5, area 6 to 20, and area 6 to 40 than control subjects. During the follow-up period, 29 patients met primary outcome. Age, slope 5, Area 6 to 20, Area 6 to 40, acute physiology and chronic health evaluation II score, multiple organ dysfunction score (MODS), logistic organ dysfunction score (LODS), and myocardial infarction history were significantly associated with primary outcome. Slope 5 showed the greatest discriminatory power. In a net reclassification improvement model, slope 5 significantly improved the predictive power of LODS; Area 6 to 20 and Area 6 to 40 significantly improved the predictive power in MODS. In an integrated discrimination improvement model, slope 5 added significantly to the prediction power of each clinical parameter. Area 6 to 20 and Area 6 to 40 significantly improved the predictive power in sequential organ failure assessment. Conclusions: MSsE provides additional prognostic information in patients receiving ECLS. 2014 Lin et al.; licensee BioMed Central Ltd.

Original language	English
Article number	548
Journal	Critical Care
Volume	18
Issue number	5
DOIs	https://doi.org/10.1186/s13054-014-0548-3
State	Published - 2014

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Lin, Y. H., Huang, H. C., Chang, Y. C., Lin, C., Lo, M. T., Daisy Liu, L. Y., Tsai, P. R., Chen, Y. S., Ko, W. J., Ho, Y. L., Chen, M. F., Peng, C. K., & Buchman, T. G. (2014). Multi-scale symbolic entropy analysis provides prognostic prediction in patients receiving extracorporeal life support. Critical Care, 18(5), Article 548. https://doi.org/10.1186/s13054-014-0548-3

@article{4fc0e614b78641d9a322dce9b004e216,

title = "Multi-scale symbolic entropy analysis provides prognostic prediction in patients receiving extracorporeal life support",

abstract = "Introduction: Extracorporeal life support (ECLS) can temporarily support cardiopulmonary function, and is occasionally used in resuscitation. Multi-scale entropy (MSE) derived from heart rate variability (HRV) is a powerful tool in outcome prediction of patients with cardiovascular diseases. Multi-scale symbolic entropy analysis (MSsE), a new method derived from MSE, mitigates the effect of arrhythmia on analysis. The objective is to evaluate the prognostic value of MSsE in patients receiving ECLS. The primary outcome is death or urgent transplantation during the index admission. Methods: Fifty-seven patients receiving ECLS less than 24 hours and 23 control subjects were enrolled. Digital 24-hour Holter electrocardiograms were recorded and three MSsE parameters (slope 5, Area 6-20, Area 6-40) associated with the multiscale correlation and complexity of heart beat fluctuation were calculated. Results: Patients receiving ECLS had significantly lower value of slope 5, area 6 to 20, and area 6 to 40 than control subjects. During the follow-up period, 29 patients met primary outcome. Age, slope 5, Area 6 to 20, Area 6 to 40, acute physiology and chronic health evaluation II score, multiple organ dysfunction score (MODS), logistic organ dysfunction score (LODS), and myocardial infarction history were significantly associated with primary outcome. Slope 5 showed the greatest discriminatory power. In a net reclassification improvement model, slope 5 significantly improved the predictive power of LODS; Area 6 to 20 and Area 6 to 40 significantly improved the predictive power in MODS. In an integrated discrimination improvement model, slope 5 added significantly to the prediction power of each clinical parameter. Area 6 to 20 and Area 6 to 40 significantly improved the predictive power in sequential organ failure assessment. Conclusions: MSsE provides additional prognostic information in patients receiving ECLS. 2014 Lin et al.; licensee BioMed Central Ltd.",

author = "Lin, {Yen Hung} and Huang, {Hui Chun} and Chang, {Yi Chung} and Chen Lin and Lo, {Men Tzung} and {Daisy Liu}, {Li Yu} and Tsai, {Pi Ru} and Chen, {Yih Sharng} and Ko, {Wen Je} and Ho, {Yi Lwun} and Chen, {Ming Fong} and Peng, {Chung Kang} and Buchman, {Timothy G.}",

note = "Funding Information: The authors would like to thank the staff of General Clinical Trial and Research in National Taiwan University Hospital for their great support. This study was supported by National Taiwan University Hospital (grants NTU 102-S2096), National Taiwan University (National Taiwan University Cutting-Edge Steering Research 10R71608-1), Ministry of Science and Technology (MOST 103-2220-E-002 -011, MOST 103-2221-E-008-006-MY3), Ministry of Science and Technology support for the Center for Dynamical Biomarkers and Translational Medicine, National Central University, Taiwan (NSC 102-2911-I-008-001), and the joint foundations (Grant No 103CGH-NCU-A1, VGHUST103-G1-3-3). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.",

year = "2014",

doi = "10.1186/s13054-014-0548-3",

language = "???core.languages.en_GB???",

volume = "18",

journal = "Critical Care",

issn = "1364-8535",

number = "5",

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TY - JOUR

T1 - Multi-scale symbolic entropy analysis provides prognostic prediction in patients receiving extracorporeal life support

AU - Lin, Yen Hung

AU - Huang, Hui Chun

AU - Chang, Yi Chung

AU - Lin, Chen

AU - Lo, Men Tzung

AU - Daisy Liu, Li Yu

AU - Tsai, Pi Ru

AU - Chen, Yih Sharng

AU - Ko, Wen Je

AU - Ho, Yi Lwun

AU - Chen, Ming Fong

AU - Peng, Chung Kang

AU - Buchman, Timothy G.

N1 - Funding Information: The authors would like to thank the staff of General Clinical Trial and Research in National Taiwan University Hospital for their great support. This study was supported by National Taiwan University Hospital (grants NTU 102-S2096), National Taiwan University (National Taiwan University Cutting-Edge Steering Research 10R71608-1), Ministry of Science and Technology (MOST 103-2220-E-002 -011, MOST 103-2221-E-008-006-MY3), Ministry of Science and Technology support for the Center for Dynamical Biomarkers and Translational Medicine, National Central University, Taiwan (NSC 102-2911-I-008-001), and the joint foundations (Grant No 103CGH-NCU-A1, VGHUST103-G1-3-3). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

PY - 2014

Y1 - 2014

N2 - Introduction: Extracorporeal life support (ECLS) can temporarily support cardiopulmonary function, and is occasionally used in resuscitation. Multi-scale entropy (MSE) derived from heart rate variability (HRV) is a powerful tool in outcome prediction of patients with cardiovascular diseases. Multi-scale symbolic entropy analysis (MSsE), a new method derived from MSE, mitigates the effect of arrhythmia on analysis. The objective is to evaluate the prognostic value of MSsE in patients receiving ECLS. The primary outcome is death or urgent transplantation during the index admission. Methods: Fifty-seven patients receiving ECLS less than 24 hours and 23 control subjects were enrolled. Digital 24-hour Holter electrocardiograms were recorded and three MSsE parameters (slope 5, Area 6-20, Area 6-40) associated with the multiscale correlation and complexity of heart beat fluctuation were calculated. Results: Patients receiving ECLS had significantly lower value of slope 5, area 6 to 20, and area 6 to 40 than control subjects. During the follow-up period, 29 patients met primary outcome. Age, slope 5, Area 6 to 20, Area 6 to 40, acute physiology and chronic health evaluation II score, multiple organ dysfunction score (MODS), logistic organ dysfunction score (LODS), and myocardial infarction history were significantly associated with primary outcome. Slope 5 showed the greatest discriminatory power. In a net reclassification improvement model, slope 5 significantly improved the predictive power of LODS; Area 6 to 20 and Area 6 to 40 significantly improved the predictive power in MODS. In an integrated discrimination improvement model, slope 5 added significantly to the prediction power of each clinical parameter. Area 6 to 20 and Area 6 to 40 significantly improved the predictive power in sequential organ failure assessment. Conclusions: MSsE provides additional prognostic information in patients receiving ECLS. 2014 Lin et al.; licensee BioMed Central Ltd.

AB - Introduction: Extracorporeal life support (ECLS) can temporarily support cardiopulmonary function, and is occasionally used in resuscitation. Multi-scale entropy (MSE) derived from heart rate variability (HRV) is a powerful tool in outcome prediction of patients with cardiovascular diseases. Multi-scale symbolic entropy analysis (MSsE), a new method derived from MSE, mitigates the effect of arrhythmia on analysis. The objective is to evaluate the prognostic value of MSsE in patients receiving ECLS. The primary outcome is death or urgent transplantation during the index admission. Methods: Fifty-seven patients receiving ECLS less than 24 hours and 23 control subjects were enrolled. Digital 24-hour Holter electrocardiograms were recorded and three MSsE parameters (slope 5, Area 6-20, Area 6-40) associated with the multiscale correlation and complexity of heart beat fluctuation were calculated. Results: Patients receiving ECLS had significantly lower value of slope 5, area 6 to 20, and area 6 to 40 than control subjects. During the follow-up period, 29 patients met primary outcome. Age, slope 5, Area 6 to 20, Area 6 to 40, acute physiology and chronic health evaluation II score, multiple organ dysfunction score (MODS), logistic organ dysfunction score (LODS), and myocardial infarction history were significantly associated with primary outcome. Slope 5 showed the greatest discriminatory power. In a net reclassification improvement model, slope 5 significantly improved the predictive power of LODS; Area 6 to 20 and Area 6 to 40 significantly improved the predictive power in MODS. In an integrated discrimination improvement model, slope 5 added significantly to the prediction power of each clinical parameter. Area 6 to 20 and Area 6 to 40 significantly improved the predictive power in sequential organ failure assessment. Conclusions: MSsE provides additional prognostic information in patients receiving ECLS. 2014 Lin et al.; licensee BioMed Central Ltd.

UR - http://www.scopus.com/inward/record.url?scp=84964697684&partnerID=8YFLogxK

U2 - 10.1186/s13054-014-0548-3

DO - 10.1186/s13054-014-0548-3

M3 - 期刊論文

C2 - 25341381

AN - SCOPUS:84964697684

SN - 1364-8535

VL - 18

JO - Critical Care

JF - Critical Care

IS - 5

M1 - 548

ER -

Multi-scale symbolic entropy analysis provides prognostic prediction in patients receiving extracorporeal life support

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