Heart rates in hospitalized children by age and body temperature.

TitleHeart rates in hospitalized children by age and body temperature.
Publication TypeJournal Article
Year of Publication2015
AuthorsDaymont C, Bonafide CP, Brady PW
JournalPediatrics
Volume135
Issue5
Paginatione1173-81
Date Published05/2015
ISSN1098-4275
KeywordsAdolescent, Age Factors, Body Temperature, Child, Child, Hospitalized, Child, Preschool, Female, Heart Rate, Humans, Infant, Infant, Newborn, Male, Reference Values, Retrospective Studies
Abstract

BACKGROUND AND OBJECTIVES: Heart rate (HR) is frequently used by clinicians in the hospital to assess a patient's severity of illness and make treatment decisions. We sought to develop percentiles that characterize the relationship of expected HR by age and body temperature in hospitalized children and to compare these percentiles with published references in both primary care and emergency department (ED) settings.

METHODS: Vital sign data were extracted from electronic health records of inpatients <18 years of age at 2 large freestanding children's hospitals from July 2011 to June 2012. We selected up to 10 HR-temperature measurement pairs from each admission. Measurements from 60% of patients were used to derive the percentile curves, with the remainder used for validation. We compared our upper percentiles with published references in primary care and ED settings.

RESULTS: We used 60,863 observations to derive the percentiles. Overall, an increase in body temperature of 1°C was associated with an increase of ∼ 10 beats per minute in HR, although there were variations across age and temperature ranges. For infants and young children, our upper percentiles were lower than in primary care and ED settings. For school-age children, our upper percentiles were higher.

CONCLUSIONS: We characterized expected HR by age and body temperature in hospitalized children. These percentiles differed from references in primary care and ED settings. Additional research is needed to evaluate the performance of these percentiles for the identification of children who would benefit from further evaluation or intervention for tachycardia.

DOI10.1542/peds.2014-3738
Alternate JournalPediatrics
PubMed ID25917984
PubMed Central IDPMC4411783
Grant ListK23HL116427 / HL / NHLBI NIH HHS / United States