Prevalence of prolonged corrected QT interval and its impact on outcomes in patients admitted in medical intensive care unit

Authors

  • Pandharinath S. Gawali Department of General Medicine, Indian Institute of Medical Science and Research Medical College, Badnapur, Jalna, Maharashtra, India
  • Sachin N. Solanke Department of General Medicine, Indian Institute of Medical Science and Research Medical College, Badnapur, Jalna, Maharashtra, India
  • Sudhir L. Tungikar Department of General Medicine, Indian Institute of Medical Science and Research Medical College, Badnapur, Jalna, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20183856

Keywords:

Corrected QT interval, Intensive Care Unit (ICU), Prevalence

Abstract

Background: The long QT syndrome (LQTS) is a disorder of myocardial repolarization characterized by a prolonged QT interval on the electrocardiogram (ECG). Hence the present study was aimed to determine prevalence of QT prolongation of the ECG and to assess its impact on outcomes in patients admitted in medical ICU of Noor Hospital of IIMSR Medical College, Badnapur, Jalna, Maharashtra, India.

Methods: This prospective observational study was carried out during the period of October 2016 to March 2018, for assessment of prevalence of prolonged QTc at admission and its impact on outcomes in medical ICU. QTc calculated by bazett’s formula of >440 ms for males and >460 ms for females was considered as prolonged. Details of illness, clinical observations and laboratory parameters were also monitored.

Results: The total 150 patients were studied and there was a high prevalence (32%) of prolonged QTc at admission to the ICU which reduced to 20.5% on day 3. Patients with prolonged QTc were found to be at high risk for adverse outcomes and their ICU and hospital stay was more.

Conclusions: The study concluded that prolonged QTc is common in authors’ medical ICU at admission (32%). Patients with QTc prolongation were at higher risk for adverse outcomes and their ICU and hospital stay was more.

References

Ferreira FL, Bota DP, Bross A, Mélot C, Vincent JL. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001 Oct 10;286(14):1754-8.

Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Critical Care Med. 1985 Oct;13(10):818-29.

Goldhill DR, Sumner A. Outcome of intensive care patients in a group of British intensive care units. Critical Care Med. 1998 Aug 1;26(8):1337-45.

Shadnia S, Okazi A, Akhlaghi N, Sasanian G, Abdollahi M. Prognostic value of long QT interval in acute and severe organophosphate poisoning. J Med Toxicol. 2009 Dec 1;5(4):196-9.

Kozik TM, Wung SF. Acquired long QT syndrome: frequency, onset, and risk factors in intensive care patients. Critical Care Nurse. 2012 Oct 1;32(5):32-41.

George TK, David Chase, Peter JV, Satytendra S, Kavitha R, George LR, et al. Association between a prolonged corrected QT interval and outcomes in patients in a medical Intensive Care Unit. Indian J Critical Care Med. 2005;19(6):326-32.

Mabasa VH, Yokoyama S, Damen Man JM. Analysis of orders for QTc-prolonging medication for intensive and cardiac care unit patients with pre-existing QTc prolongation (QTIPPP study). The Canadian J Hospital Pharma. 2011 Nov;64(6):412-8.

Tisdale JE, Wroblewski HA, Overholser BR, Kingery JR, Trujillo TN, Kovacs RJ. Prevalence of QT interval prolongation in patients admitted to cardiac care units and frequency of subsequent administration of QT interval-prolonging drugs. Drug Saf. 2012 Jun 1;35(6):459-70.

Pickham D, Helfenbein E, Shinn JA, Chan G, Funk M, Weinacker A, et al. High prevalence of corrected QT interval prolongation in acutely ill patients is associated with mortality: results of the QT in Practice (QTIP) Study. Critical Care Med. 2012 Feb 1;40(2):394-9.

Haugaa KH, Bos JM, Tarrell RF, Morlan BW, Caraballo PJ, Ackerman MJ. Institution-wide QT alert system identifies patients with a high risk of mortality. Mayo Clinic Proceedings. 2013 Apr 1;88(4):315-25.

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Published

2018-09-22

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Original Research Articles