Journal of Biometrics & Biostatistics

A Joint Model for a Longitudinal Pulse Rate and Respiratory Rate of Congestive Heart Failure Patients: at Ayder Referral Hospital of Mekelle University, Tigray, Ethiopia

Abstract

Yemane Hailu Fissuh and Geremew Muleta

Pulse rate(PR) and respiratory rates(RR) are main symptoms of congestive heart failure(CHF) and the abnormal PR and RR are broad indicators of major physiological instabilities. The lower PR and RR are associated with a strong and healthier heart. CHF 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. The main objective of this study is, to investigate the joint evolution of PR and RR of CHF patients and identify the potential risk factors affecting the two end points. The latest data from Sep.2012 up to Aug.2013 have been taken from medical charts of 264 adult CHF patients to model separate and joint linear mixed effect for PR and RR. The baseline mean and standard deviation of PR and RR are 126.11 and 18.98 and 31.64 and 10.99 respectively. The association of the evolution for PR and RR was estimated to be (ρ=0.7054) which is statistically significant with 95% CI of (0.642, 0.769). PR and RR showed a decreasing pattern over time in both joint and separate models. Furthermore, a positive and significant association was observed between the two end points and all covariates except LVEF and time. Finally, to identify associated effect fitting joint model for paired endpoints is recommended.