{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T14:52:06Z","timestamp":1777733526658,"version":"3.51.4"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Heart rate is one of the important vital signs. Many studies have done a lot of meaningful research on heart rate in sepsis patients. However, the heart rates of sepsis patients were repeatedly measured after their admission to intensive care unit (ICU). The trajectory of these changes was observed, but the impact of this trajectory on the short-term mortality prognosis for sepsis remains unclear. This study was performed to investigate impact of repeated changes in heart rate on short-term all-cause mortality among sepsis patients was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>In this retrospective study of data on sepsis patients from the Medical Information Mart for Intensive Care (MIMIC) IV database, the outcome was short-term mortality. The measured heart rate of sepsis patients 10\u00a0h post-admission to ICU was extracted, with 1\u00a0h between each measurement. Latent growth mixture modelling (LGMM) was used to classify heart rate trajectories, while Kaplan\u2013Meier (K-M) and Cox proportional hazards models were employed to analyze differences in survival between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>This study enrolled 5511 sepsis patients, and six different heart rate trajectories were identified based on model-fit criteria. Class 1: heart rate stable at 80\u00a0bpm; class 2: consistently 92\u00a0bpm; class 3: briefly stable, then declining; class 4: steady at 110\u00a0bpm; class 5: fluctuating around 65\u00a0bpm; class 6: stable at 128\u00a0bpm. The K-M analysis indicated sepsis patients in class1 had the highest survival probability, and the class3 had the lowest survival probability. After adjusting for all potential confounding factors, the Cox proportional hazard model showed that compared with class 1, the hazard ratios (HRs) with 95% confidence intervals (CIs) for classes 2, 3, 4, 5, and 6 were 1.28 (1.09, 1.50), 1.88 (1.38, 2.56), 1.49 (1.26, 1.76), 1.24 (1.03, 1.48), and 1.30 (1.02, 1.66), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Maintaining a sustained heart rate of approximately 80 beats per minute during the initial 10-hour period post-ICU admission may be associated with improved short-term outcomes in patients with sepsis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-025-11961-9","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T14:28:46Z","timestamp":1765290526000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Influence of heart rate trajectory in 30-day mortality in sepsis patients: a retrospective study based on the MIMIC-IV database"],"prefix":"10.1186","volume":"25","author":[{"given":"Wenming","family":"Shao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianlong","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanbin","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yabin","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luming","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Lyu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haiyan","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"issue":"1","key":"11961_CR1","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1001\/jama.2014.5804","volume":"312","author":"V Liu","year":"2014","unstructured":"Liu V, Escobar GJ, Greene JD, Soule J, Whippy A, Angus DC, Iwashyna TJ. Hospital deaths in patients with sepsis from 2 independent cohorts. JAMA. 2014;312(1):90\u20132.","journal-title":"JAMA"},{"issue":"9749","key":"11961_CR2","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1016\/S0140-6736(10)60446-1","volume":"376","author":"NK Adhikari","year":"2010","unstructured":"Adhikari NK, Fowler RA, Bhagwanjee S, Rubenfeld GD. Critical care and the global burden of critical illness in adults. Lancet. 2010;376(9749):1339\u201346.","journal-title":"Lancet"},{"key":"11961_CR3","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.cytogfr.2017.04.002","volume":"35","author":"K Dendoncker","year":"2017","unstructured":"Dendoncker K, Libert C. Glucocorticoid resistance as a major drive in sepsis pathology. Cytokine Growth Factor Rev. 2017;35:85\u201396.","journal-title":"Cytokine Growth Factor Rev"},{"issue":"9","key":"11961_CR4","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1007\/s40273-015-0282-y","volume":"33","author":"B Tiru","year":"2015","unstructured":"Tiru B, DiNino EK, Orenstein A, Mailloux PT, Pesaturo A, Gupta A, McGee WT. The economic and humanistic burden of severe sepsis. PharmacoEconomics. 2015;33(9):925\u201337.","journal-title":"PharmacoEconomics"},{"issue":"10219","key":"11961_CR5","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","volume":"395","author":"KE Rudd","year":"2020","unstructured":"Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, Colombara DV, Ikuta KS, Kissoon N, Finfer S, et al. Global, regional, and National sepsis incidence and mortality, 1990\u20132017: analysis for the global burden of disease study. Lancet. 2020;395(10219):200\u201311.","journal-title":"Lancet"},{"issue":"5","key":"11961_CR6","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1056\/NEJMp1707170","volume":"377","author":"K Reinhart","year":"2017","unstructured":"Reinhart K, Daniels R, Kissoon N, Machado FR, Schachter RD, Finfer S. Recognizing sepsis as a global health Priority - A WHO resolution. N Engl J Med. 2017;377(5):414\u20137.","journal-title":"N Engl J Med"},{"issue":"8","key":"11961_CR7","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1111\/1440-1681.12415","volume":"42","author":"H Ebelt","year":"2015","unstructured":"Ebelt H, Gei\u00dfler I, Ruccius S, Otto V, Hoffmann S, Korth H, Kl\u00f6ckner U, Zhang Y, Li Y, Grossmann C, et al. Direct inhibition, but indirect sensitization of pacemaker activity to sympathetic tone by the interaction of endotoxin with HCN-channels. Clin Exp Pharmacol Physiol. 2015;42(8):874\u201380.","journal-title":"Clin Exp Pharmacol Physiol"},{"issue":"19","key":"11961_CR8","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1056\/NEJMoa010307","volume":"345","author":"E Rivers","year":"2001","unstructured":"Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345(19):1368\u201377.","journal-title":"N Engl J Med"},{"key":"11961_CR9","doi-asserted-by":"publisher","unstructured":"Johnson A, Bulgarelli L, Pollard T, Horng S, Celi LA, Mark R. MIMIC-IV (version 2.0). PhysioNet. 2022. RRID:SCR_007345. Available from: https:\/\/doi.org\/10.13026\/7vcr-e114","DOI":"10.13026\/7vcr-e114"},{"issue":"1","key":"11961_CR10","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1111\/jebm.12373","volume":"13","author":"J Yang","year":"2020","unstructured":"Yang J, Li Y, Liu Q, Li L, Feng A, Wang T, Zheng S, Xu A, Lyu J. Brief introduction of medical database and data mining technology in big data era. J Evid Based Med. 2020;13(1):57\u201369.","journal-title":"J Evid Based Med"},{"issue":"8","key":"11961_CR11","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1001\/jama.2016.0287","volume":"315","author":"M Singer","year":"2016","unstructured":"Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801\u201310.","journal-title":"JAMA"},{"issue":"1","key":"11961_CR12","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/s13054-020-2768-z","volume":"24","author":"Z Zhang","year":"2020","unstructured":"Zhang Z, Ho KM, Gu H, Hong Y, Yu Y. Defining persistent critical illness based on growth trajectories in patients with sepsis. Crit Care. 2020;24(1):57.","journal-title":"Crit Care"},{"issue":"1","key":"11961_CR13","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1186\/s13054-021-03586-6","volume":"25","author":"J Eriksson","year":"2021","unstructured":"Eriksson J, Nelson D, Holst A, Hellgren E, Friman O, Oldner A. Temporal patterns of organ dysfunction after severe trauma. Crit Care. 2021;25(1):165.","journal-title":"Crit Care"},{"issue":"2","key":"11961_CR14","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1080\/10705511.2014.882690","volume":"21","author":"SY Kim","year":"2014","unstructured":"Kim SY. Determining the number of latent classes in Single- and Multi-Phase growth mixture models. Struct Equ Model. 2014;21(2):263\u201379.","journal-title":"Struct Equ Model"},{"key":"11961_CR15","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1111\/j.1749-6632.1990.tb37302.x","volume":"601","author":"MN Levy","year":"1990","unstructured":"Levy MN. Autonomic interactions in cardiac control. Ann N Y Acad Sci. 1990;601:209\u201321.","journal-title":"Ann N Y Acad Sci"},{"issue":"6","key":"11961_CR16","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1097\/shk.0b013e31812386bf","volume":"28","author":"K Zorn-Pauly","year":"2007","unstructured":"Zorn-Pauly K, Pelzmann B, Lang P, M\u00e4chler H, Schmidt H, Ebelt H, Werdan K, Koidl B. M\u00fcller-Werdan U: endotoxin impairs the human pacemaker current if. Shock. 2007;28(6):655\u201361.","journal-title":"Shock"},{"issue":"9","key":"11961_CR17","doi-asserted-by":"publisher","first-page":"1994","DOI":"10.1097\/01.CCM.0000178181.91250.99","volume":"33","author":"H Schmidt","year":"2005","unstructured":"Schmidt H, M\u00fcller-Werdan U, Hoffmann T, Francis DP, Piepoli MF, Rauchhaus M, Prondzinsky R, Loppnow H, Buerke M, Hoyer D, et al. Autonomic dysfunction predicts mortality in patients with multiple organ dysfunction syndrome of different age groups. Crit Care Med. 2005;33(9):1994\u20132002.","journal-title":"Crit Care Med"},{"issue":"1","key":"11961_CR18","doi-asserted-by":"publisher","first-page":"R14","DOI":"10.1186\/cc7712","volume":"13","author":"O Joulin","year":"2009","unstructured":"Joulin O, Marechaux S, Hassoun S, Montaigne D, Lancel S, Neviere R. Cardiac force-frequency relationship and frequency-dependent acceleration of relaxation are impaired in LPS-treated rats. Crit Care. 2009;13(1):R14.","journal-title":"Crit Care"},{"issue":"2","key":"11961_CR19","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/s00392-011-0375-3","volume":"101","author":"RS Hoke","year":"2012","unstructured":"Hoke RS, M\u00fcller-Werdan U, Lautenschl\u00e4ger C, Werdan K, Ebelt H. Heart rate as an independent risk factor in patients with multiple organ dysfunction: a prospective, observational study. Clin Res Cardiol. 2012;101(2):139\u201347.","journal-title":"Clin Res Cardiol"},{"issue":"2","key":"11961_CR20","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1097\/CCM.0000000000002065","volume":"45","author":"SJ Beesley","year":"2017","unstructured":"Beesley SJ, Wilson EL, Lanspa MJ, Grissom CK, Shahul S, Talmor D, Brown SM. Relative bradycardia in patients with septic shock requiring vasopressor therapy. Crit Care Med. 2017;45(2):225\u201333.","journal-title":"Crit Care Med"},{"issue":"6","key":"11961_CR21","doi-asserted-by":"publisher","first-page":"2289","DOI":"10.1016\/j.chest.2021.01.009","volume":"159","author":"D Hasegawa","year":"2021","unstructured":"Hasegawa D, Sato R, Prasitlumkum N, Nishida K, Takahashi K, Yatabe T, Nishida O. Effect of Ultrashort-Acting \u03b2-Blockers on mortality in patients with sepsis with persistent tachycardia despite initial resuscitation: A systematic review and Meta-analysis of randomized controlled trials. Chest. 2021;159(6):2289\u2013300.","journal-title":"Chest"},{"key":"11961_CR22","unstructured":"Brunkhorst FM, Adamzik M, Axer H, Bauer M, Bode C, Bone HG, Brenner T, Bucher M, David S, Dietrich M et al. [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025]. Med Klin Intensivmed Notfmed 2025."},{"issue":"10","key":"11961_CR23","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1007\/s00134-024-07587-1","volume":"50","author":"S Rehberg","year":"2024","unstructured":"Rehberg S, Frank S, \u010cern\u00fd V, Cihl\u00e1\u0159 R, Borgstedt R, Biancofiore G, Guarracino F, Schober A, Trimmel H, Pernerstorfer T, et al. Landiolol for heart rate control in patients with septic shock and persistent tachycardia. A multicenter randomized clinical trial (Landi-SEP). Intensive Care Med. 2024;50(10):1622\u201334.","journal-title":"Intensive Care Med"},{"issue":"1","key":"11961_CR24","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1186\/s13054-024-05174-w","volume":"28","author":"MG Alexandru","year":"2024","unstructured":"Alexandru MG, Niewald P, Kr\u00fcger S, Borgstedt R, Whitehouse T, Singer M, Rehberg S, Scholz SS. Mortality in septic patients treated with short-acting betablockers: a comprehensive meta-analysis of randomized controlled trials. Crit Care. 2024;28(1):392.","journal-title":"Crit Care"},{"key":"11961_CR25","doi-asserted-by":"publisher","first-page":"1105894","DOI":"10.3389\/fmed.2023.1105894","volume":"10","author":"SY Hong","year":"2023","unstructured":"Hong SY, Lai CC, Teng NC, Chen CH, Hsu CC, Chan NJ, Wang CY, Wang YH, Lin YS, Chen L. Premorbid use of selective beta-blockers improves sepsis incidence and course: human cohort and animal model studies. Front Med (Lausanne). 2023;10:1105894.","journal-title":"Front Med (Lausanne)"},{"issue":"1","key":"11961_CR26","doi-asserted-by":"publisher","first-page":"20843","DOI":"10.1038\/s41598-022-25253-8","volume":"12","author":"L Schneider","year":"2022","unstructured":"Schneider L, Chalmers D, O\u2019Beirn S, Greenberg M, Cave G. Premorbid beta Blockade in sepsis is associated with a lower risk of a lactate concentration above the lactate threshold, a retrospective cohort study. Sci Rep. 2022;12(1):20843.","journal-title":"Sci Rep"},{"key":"11961_CR27","doi-asserted-by":"publisher","first-page":"1121444","DOI":"10.3389\/fcimb.2023.1121444","volume":"13","author":"CL Ge","year":"2023","unstructured":"Ge CL, Zhang LN, Ai YH, Chen W, Ye ZW, Zou Y, Peng QY. Effect of \u03b2-blockers on mortality in patients with sepsis: A propensity-score matched analysis. Front Cell Infect Microbiol. 2023;13:1121444.","journal-title":"Front Cell Infect Microbiol"},{"key":"11961_CR28","doi-asserted-by":"publisher","first-page":"107424842311859","DOI":"10.1177\/10742484231185985","volume":"28","author":"Q Liang","year":"2023","unstructured":"Liang Q, Li L, Chen K, An S, Deng Z, Li J, Zhou S, Chen Z, Zeng Z, An S. Effect of Esmolol on clinical outcomes in critically ill patients: data from the MIMIC-IV database. J Cardiovasc Pharmacol Ther. 2023;28:10742484231185985.","journal-title":"J Cardiovasc Pharmacol Ther"},{"issue":"1","key":"11961_CR29","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.chest.2024.08.020","volume":"167","author":"R Sato","year":"2025","unstructured":"Sato R, Messina S, Hasegawa D, Santonocito C, Scimonello G, Sanfilippo G, Morelli A, Dugar S, Sanfilippo F. Mortality in patients with sepsis treated with Esmolol or landiolol: A systematic review and Meta-Analysis of randomized controlled trials with trial sequential analysis. Chest. 2025;167(1):121\u201338.","journal-title":"Chest"},{"issue":"9744","key":"11961_CR30","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/S0140-6736(10)61198-1","volume":"376","author":"K Swedberg","year":"2010","unstructured":"Swedberg K, Komajda M, B\u00f6hm M, Borer JS, Ford I, Dubost-Brama A, Lerebours G, Tavazzi L. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet. 2010;376(9744):875\u201385.","journal-title":"Lancet"},{"issue":"4","key":"11961_CR31","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1097\/SHK.0000000000000992","volume":"49","author":"S Nuding","year":"2018","unstructured":"Nuding S, Schr\u00f6der J, Presek P, Wienke A, M\u00fcller-Werdan U, Ebelt H, Werdan K. Reducing elevated heart rates in patients with multiple organ dysfunction syndrome with the if (Funny channel Current) inhibitor ivabradine. Shock. 2018;49(4):402\u201311.","journal-title":"Shock"},{"issue":"3","key":"11961_CR32","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1097\/QCO.0000000000001102","volume":"38","author":"DL Stevens","year":"2025","unstructured":"Stevens DL, Bryant AE. Complexities of cardiomyopathy in septic shock. Curr Opin Infect Dis. 2025;38(3):214\u201321.","journal-title":"Curr Opin Infect Dis"},{"issue":"1","key":"11961_CR33","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/s13613-021-00869-7","volume":"11","author":"M Carrara","year":"2021","unstructured":"Carrara M, Ferrario M, Bollen Pinto B, Herpain A. The autonomic nervous system in septic shock and its role as a future therapeutic target: a narrative review. Ann Intensive Care. 2021;11(1):80.","journal-title":"Ann Intensive Care"},{"issue":"1","key":"11961_CR34","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s44158-023-00126-2","volume":"3","author":"F Guarracino","year":"2023","unstructured":"Guarracino F, Cortegiani A, Antonelli M, Behr A, Biancofiore G, Del Gaudio A, Forfori F, Galdieri N, Grasselli G, Paternoster G, et al. The role of beta-blocker drugs in critically ill patients: a SIAARTI expert consensus statement. J Anesth Analg Crit Care. 2023;3(1):41.","journal-title":"J Anesth Analg Crit Care"},{"issue":"3","key":"11961_CR35","first-page":"120","volume":"3","author":"G Davidovic","year":"2013","unstructured":"Davidovic G, Iric-Cupic V, Milanov S, Dimitijevic A, Petrovic-Janicijevic M. When heart goes BOOM to fast. Heart rate greater than 80 as mortality predictor in acute myocardial infarction. Am J Cardiovasc Dis. 2013;3(3):120\u20138.","journal-title":"Am J Cardiovasc Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-025-11961-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-025-11961-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-025-11961-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T14:28:48Z","timestamp":1765290528000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-025-11961-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,9]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["11961"],"URL":"https:\/\/doi.org\/10.1186\/s12879-025-11961-9","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,9]]},"assertion":[{"value":"16 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study involved the analysis of a third-party anonymized publicly available database with preexisting institutional review board (IRB) approval. The data extracted from the MIMIC-IV database do not require individual informed consent because the MIMIC-IV database research data are publicly available and all patient data are deidentified. The database was approved by the Institutional Review Board of the Massachusetts Institute of Technology and Beth Israel Deaconess Medical Center. To protect patient privacy, all private information in the database depository was removed. Thus, informed consent and the ethical approval statement were waived for this study. The study was consistent with the Declaration of Helsinki compliant principles.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1702"}}