Review of current knowledge regarding usage of pre-hospital heart rate variability and complexity in triage and added value for predicting the need for life-saving interventions
Dublin Core
Title
Review of current knowledge regarding usage of pre-hospital heart rate variability and complexity in triage and added value for predicting the need for life-saving interventions
Subject
Analysis of heart rate variability metrics has shown added accuracy in pre-hospital trauma triage.
Description
Abstract
Background & aim Analysis of heart rate variability metrics has shown added accuracy in pre-hospital trauma triage.
These metrics include heart rate variability (HRV), meaning oscillations in the time interval between heartbeats, and
heart rate complexity (HRC), which assesses intricate patterns of heart rate over time. This review article evaluates
current knowledge regarding HRV and HRC and prediction of a subsequent life-saving intervention (LSI), an
intervention executed by trained medical personnel to prolong the life of the patient. Our primary focus was on pre-
hospital patients and the utility of HRV and HRC when added to existing trauma triage scores or vital signs such as
heart rate (HR).
Methode A literature search was carried out by searching the MEDLINE database via the PubMed website for original
research published in English from 2008 to 2023. The combinations of search terms applied yielded 18 original studies
of which only six met our criteria. We included another study as it contributed original research beneficial to our
article.
Results The studies showed a statistically significant increase in the ∆Area Under Curve (AUC) between 0.14 and
0.40 for predicting risk of LSI when adding the two heart rate variability metrics to existing trauma triage scores or
vital signs such as HR. Calculation of HRV and/or HRC could be conducted using ECG recording hardware already
accessible in most emergency pre-hospital settings with less ECG noise and therefore higher quality ECG data over
time.
Conclusion Both HRV and HRC showed potential for increasing ∆AUC in predicting risk of LSI when added to existing
risk triage scores. Calculation of HRV and HRC could potentially be conducted using a preexisting hardware in most
emergency pre-hospital settings.
Background & aim Analysis of heart rate variability metrics has shown added accuracy in pre-hospital trauma triage.
These metrics include heart rate variability (HRV), meaning oscillations in the time interval between heartbeats, and
heart rate complexity (HRC), which assesses intricate patterns of heart rate over time. This review article evaluates
current knowledge regarding HRV and HRC and prediction of a subsequent life-saving intervention (LSI), an
intervention executed by trained medical personnel to prolong the life of the patient. Our primary focus was on pre-
hospital patients and the utility of HRV and HRC when added to existing trauma triage scores or vital signs such as
heart rate (HR).
Methode A literature search was carried out by searching the MEDLINE database via the PubMed website for original
research published in English from 2008 to 2023. The combinations of search terms applied yielded 18 original studies
of which only six met our criteria. We included another study as it contributed original research beneficial to our
article.
Results The studies showed a statistically significant increase in the ∆Area Under Curve (AUC) between 0.14 and
0.40 for predicting risk of LSI when adding the two heart rate variability metrics to existing trauma triage scores or
vital signs such as HR. Calculation of HRV and/or HRC could be conducted using ECG recording hardware already
accessible in most emergency pre-hospital settings with less ECG noise and therefore higher quality ECG data over
time.
Conclusion Both HRV and HRC showed potential for increasing ∆AUC in predicting risk of LSI when added to existing
risk triage scores. Calculation of HRV and HRC could potentially be conducted using a preexisting hardware in most
emergency pre-hospital settings.
Creator
Christoffer B. Hedegaard1*, Kasper Iversen1,2,3, Fredrik Folke1,3,4, Morten Lock-Hansen6
, Carolina Malta Hansen1,3,4 and
Jannik Pallisgaard5
, Carolina Malta Hansen1,3,4 and
Jannik Pallisgaard5
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Christoffer B. Hedegaard1*, Kasper Iversen1,2,3, Fredrik Folke1,3,4, Morten Lock-Hansen6
, Carolina Malta Hansen1,3,4 and
Jannik Pallisgaard5, “Review of current knowledge regarding usage of pre-hospital heart rate variability and complexity in triage and added value for predicting the need for life-saving interventions,” Repository Horizon University Indonesia, accessed April 18, 2026, https://repository.horizon.ac.id/items/show/13263.