{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:25:13Z","timestamp":1759537513896,"version":"build-2065373602"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Heart Rate Variability (HRV) is a dynamic reflection of heart rhythm regulation by various physiological inputs. HRV deviations have been found to correlate with clinical outcomes in patients under physiological stresses. Perioperative cardiovascular complications occur in up to 5% of adult patients undergoing abdominal surgery and are associated with significantly increased mortality. This pilot study aimed to develop a predictive model for post\u2010operative cardiovascular complications using HRV parameters for early risk stratification and aid post\u2010operative clinical decision\u2010making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients admitted to High Dependency Units after elective major abdominal surgery were recruited. The primary composite outcome was defined as cardiovascular complications within 7\u00a0days post\u2010operatively. ECG monitoring for HRV parameters was conducted at three time points (pre\u2010operative, immediately post\u2010operative, and post\u2010operative day 1) and analyzed based on outcome group and time interactions. Candidate HRV predictors were included in a multivariable logistic regression analysis incorporating a stepwise selection algorithm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>89 patients were included in the analysis, with 8 experiencing cardiovascular complications. Three HRV parameters, when measured immediately post\u2010operatively and composited with patient age, provided the basis for a predictive model with AUC of 0.980 (95% CI: 0.953, 1.00). The negative predictive value was 1.00 at a statistically optimal predicted probability cut\u2010off point of 0.16.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our model holds potential for accelerating clinical decision\u2010making and aiding in patient triaging post\u2010operatively, using easily acquired HRV parameters. Risk stratification with our model may enable safe early step\u2010down care in patients assessed to have a low risk profile of post\u2010operative cardiovascular complications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12077","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T11:11:46Z","timestamp":1706008306000},"page":"585-597","source":"Crossref","is-referenced-by-count":0,"title":["Using heart rate variability to develop a predictive model for post\u2010operative cardiovascular complications following major abdominal surgery: A pilot study"],"prefix":"10.1002","volume":"48","author":[{"given":"Chee Hoe","family":"Koo","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Singapore General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bai","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Singapore General Hospital  Singapore Singapore"},{"name":"Department of Anaesthesiology Singapore General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7545-9367","authenticated-orcid":false,"given":"Vanessa","family":"Yik","sequence":"additional","affiliation":[{"name":"Duke\u2010NUS Medical School  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac","family":"Seow\u2010En","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Singapore General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus Eng Hock","family":"Ong","sequence":"additional","affiliation":[{"name":"Duke\u2010NUS Medical School  Singapore Singapore"},{"name":"Department of Emergency Medicine Singapore General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emile Kwong\u2010Wei","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Singapore General Hospital  Singapore 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