Corrected <scp>QT</scp> interval anomalies are associated with worse prognosis among patients suffering from sepsis

Wasserstrum, Yishay; Lotan, Dor; Itelman, Edward; Barbarova, Irina; Kogan, Michael; Klempfner, Robert; Dagan, Amir; Segal, Gad

doi:10.1111/imj.13170

Cited by 11 publications

(10 citation statements)

References 28 publications

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“…Electrolyte imbalance or fatal arrhythmia in conjuntion with severe illness may contribute to increased mortality, but further investigation is needed. Furthermore, prolonged QTc interval is associated with a poor clinical outcome in patients with sepsis [ 22 ]. In the present study, over 40% of patients who had prolonged QTc interval on follow-up ECG died from sepsis.…”

Section: Discussionmentioning

confidence: 99%

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Corrected QT interval on the electrocardiogram after liver transplantation: Surrogate marker of poor clinical outcomes?

Lee

Park

et al. 2018

PLoS ONE

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BackgroundProlongation of corrected QT interval (QTc) on the electrocardiogram is associated with cardiac arrhythmia and sudden death. Changes in the QTc (corrected QT) interval before and after liver transplantation (LT) for the treatment of liver cirrhosis (LC) and its association with clinical outcomes have not been fully evaluated.MethodsFrom January 2011 to May 2016, consecutive 516 consecutive recipients were enrolled into LT registry and the median follow-up was 31 months (IQR 12–52). Patients with an available electrocardiogram before LT and 1 month after from LT were analyzed. Patients were divided into 2 groups according to prolonged QTc interval. The patient groups were analyzed separately according whether the electrocardiogram was preoperative or postoperative. The primary outcome was all-cause death during the follow-up period.ResultsA total of 283 patients were enrolled in the study. In the preoperative QTc prolongation group, there was not a significant rate difference in all-cause mortality in multivariate analysis (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.53–1.66; P = 0.26). However, in the postoperative QTc prolongation group, mortality was significantly increased (HR, 1.78; 95%CI, 1.05–3.03; P = 0.03) in patients who underwent LT.ConclusionIn patients who underwent LT for LC, postoperative QTc prolongation on ECG, rather than preoperative, is associated with mortality. Larger clinical trials are needed to support this finding.

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Section: Discussionmentioning

confidence: 99%

“…In consideration of our results, clinicians need to be aware of the effect of QTc prolongation and proceed cautiously with LT patients. The definition of QTc interval prolongation varies [ 16 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Corrected QT interval on the electrocardiogram after liver transplantation: Surrogate marker of poor clinical outcomes?

Lee

Park

et al. 2018

PLoS ONE

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“…Drugs are a common cause of QTc interval prolongation, and multiple medications have been withdrawn from the market over the last two decades because of their associations with Torsades de pointes and cardiovascular deaths. 2 Antimicrobials that are associated with QT prolongation include the macrolides, fluoroquinolones, antimalarials, pentamidine, protease inhibitors and azole antifungals. 3,4 Moreover, antimicrobial drugs are susceptible to pharmacokinetic and pharmacodynamic interactions with other drugs, which may increase the risk of QT prolongation and potentially arrhythmia.…”

Section: General Correspondencementioning

confidence: 99%

Association between altered QT interval in sepsis and mortality: a possible effect of antimicrobial therapy?

Overton

Post

2017

Internal Medicine Journal

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“…Multiple biomarkers can be used on admission or during follow up of patients to assess the patients' progress and predict their risk outcome with no specific superiority over each other [3,4]. Simple, available and rapid tools are needed to determine septicemic patients with high-risk mortality [5].…”

Section: Introductionmentioning

confidence: 99%

Higher accuracy of concurrent use of corrected QT interval and procalcitonin serum level to predict sepsis related mortality in ICU patients

Hashim

Abdelaziz

Hassan

2020

Egyptian Journal of Anaesthesia

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Background: Sepsis is one of the most serious conditions where early diagnosis is important to decrease mortality. We assessed the use of corrected QT (QTc) interval, and procalcitonin level (PCT) as markers in septicemia to predict the patients' short-term outcome and to get the cut off value of higher diagnostic characteristics. Material and methods: 120 ICU patients with an established diagnosis of septicemia were included. Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE II) score were evaluated for all patients. Patients' co-morbidities, risk factors, laboratory, and hemodynamic records were recorded. QTc was recorded. Also, the PCT level was measured once within the first 24 hours after the diagnosis of sepsis before antibiotic therapy. The patients under study were followed up for the short-term outcome for 14 days to be either survivors or non-survivors. Results: The mean age of our patients was 56.5 ± 6.2 years. The incidence of mortality was 36.7%. SOFA score, APACHE score, PCT level, and prolonged QTc were the parameters that showed a significant difference between the survivor and non-survivor groups. The prolonged QTc showed 70.5% sensitivity and 81.6% specificity to predict mortality. The best cut value of QTc to predict mortality was ≥ 469 ms while for PCT level was 8.4 ng/dl with 75%, 97.7% sensitivity and 81.6%, 57.9% specificity respectively. Conclusion: Prolonged QTc and procalcitonin are easy and available parameters that can be used as markers to predict the ICU patients' mortality with reasonable accuracy.

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Corrected QT interval anomalies are associated with worse prognosis among patients suffering from sepsis

Abstract: QTc duration anomalies are associated with worse short- and medium-term prognosis and may act as a marker for more severe clinical sequelae.

Cited by 11 publications

References 28 publications

Corrected QT interval on the electrocardiogram after liver transplantation: Surrogate marker of poor clinical outcomes?

Corrected QT interval on the electrocardiogram after liver transplantation: Surrogate marker of poor clinical outcomes?

Association between altered QT interval in sepsis and mortality: a possible effect of antimicrobial therapy?

Higher accuracy of concurrent use of corrected QT interval and procalcitonin serum level to predict sepsis related mortality in ICU patients

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