Relative tachycardia in patients with sepsis: An independent risk factor for mortality

L. Leibovici*, A. Gafter-Gvili, M. Paul, N. Almanasreh, E. Tacconelli, S. Andreassen, A. D. Nielsen, U. Frank, R. Cauda

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Excess activation of the sympathetic nervous system may be a risk factor for mortality in patients with the systemic inflammatory response syndrome (SIRS) or sepsis. Aim: To examine whether excessive tachycardia, relative to the degree of fever is an independent risk factor for death in patients with SIRS. Design: Prospective observational study. Setting: Departments of medicine in three university hospitals in Israel, Germany and Italy. Methods: We collected data for 3382 patients with SIRS, whether community- or hospital-acquired, 91% with sepsis, as part of an ongoing trial. Results: Overall 30-day mortality was 12% (408/3382). The pulse/ temperature ratio was significantly higher in patients who died than in survivors: mean ± SD 2.55 ± 0.57 vs. 2.40 ± 0.48 bpm/°C (p < 0.0001). Excessive tachycardia was significantly associated with a mortality in a logistic model accounting for other strong predictors of mortality (OR 1.54, 95%CI 1.10-2.17). Patients with septic shock were the only group for whom this association did not hold. Discussion: Our data are compatible with the hypothesis that some patients with sepsis experience an excess activation of the sympathetic nervous system, leading to a fatal outcome.

Original languageEnglish
Pages (from-to)629-634
Number of pages6
JournalQJM - Monthly Journal of the Association of Physicians
Issue number10
StatePublished - Oct 2007


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