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Open Access Research article

Association between Frequency Domain Heart Rate Variability and Unplanned Readmission to Hospital in Geriatric Patients

Jui-Kun Chiang12, Chin-Hua Fu34, Terry BJ Kuo5 and Malcolm Koo6*

Author Affiliations

1 Department of Family Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan

2 Department of Biotechnology, Chia Nan University of Pharmacy and Science, Tainan, Taiwan

3 Department of Neurology, Buddhist Taichung Tzu Chi General Hospital, Taichung, Taiwan

4 Medical school, Tzu Chi University, Hualien, Taiwan

5 Institute of Brain Science, National Yang Ming University, Taipei, Taiwan

6 Dalla Lana School of Public Health, University of Toronto, Canada

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BMC Public Health 2011, 11:137  doi:10.1186/1471-2458-11-137

Published: 27 February 2011



An accurate prediction of unplanned readmission (UR) after discharge from hospital can facilitate physician's decision making processes for providing better quality of care in geriatric patients. The objective of this study was to explore the association of cardiac autonomic functions as measured by frequency domain heart rate variability (HRV) and 14-day UR in geriatric patients.


Patients admitted to the geriatric ward of a regional hospital in Chiayi county in Taiwan were followed prospectively from July 2006 to June 2007. Those with invasive tubes and those who were heavy smokers, heavy alcohol drinkers, on medications that might influence HRV, or previously admitted to the hospital within 30 days were excluded. Cardiac autonomic functions were evaluated by frequency domain indices of HRV. Multiple logistic regression was used to assess the association between UR and HRV indices adjusted for age and length of hospitalization.


A total of 78 patients met the inclusion criteria and 15 of them were readmitted within 14 days after discharge. The risk of UR was significantly higher in patients with lower levels of total power (OR = 1.39; 95% CI = 1.04-2.00), low frequency power (LF) (OR = 1.22; 95% CI = 1.03-1.49), high frequency power (HF) (OR = 1.27; 95% CI = 1.02-1.64), and lower ratios of low frequency power to high frequency power (LF/HF ratio) (OR = 1.96; 95% CI = 1.07-3.84).


This is the first study to evaluate the association between frequency domain heart rate variability and the risk of UR in geriatric patients. Frequency domain heart rate variability indices measured on admission were significantly associated with increased risk of UR in geriatric patients. Additional studies are required to confirm the value and feasibility of using HRV indices on admission as a non-invasive tool to assist the prediction of UR in geriatric patients.