Abstract:
Background: Pulse rate and respiratory rates are main symptoms of congestive heart rate and the
abnormal pulse rate and respiratory rate are broad indicators of major physiological instabilities.
The lower pulse rate and respiratory rates are associated with a strong and healthier heart. CHF,
also known simply as HF, is a complex clinical syndrome that can result from any structural or
functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood.
Objective: The main objective of this study is, therefore to investigate the joint evolution of pulse
rate and respiratory rate of cognitive heart failure patients and identify the potential risk factors
affecting the two end points in Ayder referral Hospital of Mekelle University.
Methods: The latest data from 2004 E.C. up to 2005 E.C. have been taken from medical charts
of 264 adult CHF patients in Ayder Referral Hospital of Mekelle University. Linear mixed
effects model was fitted for the pulse rate and respiratory rate outcomes. Furthermore, a joint
mixed effects model was fitted for the two end points, and the potential risk factors affecting
their joint evolution are identified.
Results: The baseline mean and standard deviation of both PR & RR were 126.11 &18.98bpm
and 31.64 &10.99 brpm respectively. The association of the evolution for PR & RR was
estimated to be ( ) which is statistically significant at 1% level of significance with
95% CI of (0.642, 0.769).
Conclusions: The data analysis showed that pulse rate and respiratory rate showed a decreasing
pattern over time based on the joint as well as the separate models. Furthermore, a positive and
significant association was observed between the two end points and the covariates such as: sex,
weight, New York Heart Association classes, age and interaction of time with weight and Left
ventricle ejection fraction. While, negative and significant association was observed between two
endpoints and the covariates such as: LVEF and time. Finally, to identify associated effect fitting
joint model for paired endpoints is recommended.
