Association between a prolonged corrected QT interval and outcomes in patients in a medical Intensive Care Unit
Tarun K. George, David Chase, Sowmya Satyendra, R. Kavitha, Leah Raju George, Vineeth Varghese Thomas
Keywords :
Critical care, electrocardiography, intensive care unit, India, predictors, QT prolongation
Citation Information :
George TK, Chase D, Satyendra S, Kavitha R, George LR, Thomas VV. Association between a prolonged corrected QT interval and outcomes in patients in a medical Intensive Care Unit. Indian J Crit Care Med 2015; 19 (6):326-332.
Introduction: Patients admitted into a medical Intensive Care Unit (ICU) have varying illnesses and risk factors. An electrocardiogram (ECG) is a useful tool to assess the cardiac status. The aim of the study was to determine the prevalence of QT prolongation of the ECG in patients admitted to a medical ICU in a tertiary hospital, to assess outcomes in terms of mortality, cardiovascular events, and duration of ICU stay. Materials and Methods: Prospective observational study, 6 months duration, assessing the prevalence of prolonged corrected QT interval (QTc) at admission into a medical ICU. A QTc calculated by Bazett′s formula, of >440 ms for males and >460 ms for females was considered prolonged. Details of illness, clinical and lab parameters were monitored. Results: The total number of patients screened was 182. There was a high prevalence of prolonged QTc (30%) on admission to the ICU. This reduced to 19% on day 3 (P = 0.011). In patients with a prolonged QTc the odds ratio of adverse outcome from ICU was 3.17 (confidence interval [CI]: 1.52-6.63) (P = 0.001) and of adverse outcome for hospital stay was 2.27 (CI: 1.11-4.66) (P = 0.014). In the study, 35% of all patients received drugs with QT prolonging action. Of patients with a prolonged QTc at admission 18 (35%) received a QT prolonging drug. Conclusions: We found that prolonged QTc is common (30%) in our medical ICU at admission and a large proportion (35%) received drugs capable of prolonging QT interval. These patients with QTc prolongation have a higher odds ratio for adverse outcomes.
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