Prevalence of QTc interval changes in acute psychiatric care: A cross-sectional study

Beyraghi, Narges; Rajabi, Fariba; Hajsheikholeslami, Farhad

doi:10.3109/13651501.2012.667112

Cited by 3 publications

(5 citation statements)

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“…But the results are not consistent with another two studies where risperidone compared to olanzapine and aripiprazole had prolonged QTc compared to the latter drugs [ 24 , 26 ]. In a study of patients with methadone, QTc was prolonged nearly by 66 ms [ 13 ]. Van der sijs et al studied use of multiple drugs (haloperidol, amiodarone, sotalol), QTc prolongation was found to be 59.76 ms [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

Impact of Drug Induced Long QT Syndrome: A Systematic Review

et al. 2018

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BackgroundDrug induced long QT syndrome is quite common in daily clinical practice but its impact is unknown.MethodsPubMed and EMBASE databases (until May 2, 2017) were searched to identify studies reporting drug induced long QT syndrome and followed the PRISMA guidelines. The main outcomes measured in these studies were QTc prolongation, ventricular arrhythmias, torsade de pointes (TdP) and death.ResultsOut of 176 non-duplicate reports, 36 studies satisfied inclusion criteria and provided data on patients exposed to drugs that can potentially cause long QT. Totally, 14,756 patients were exposed and 930 patients (6.3%) were found to have QTc prolongation. The number of males was 6,400 and females were 5,723 patients. The mean age of the patients was 43.8 ± 9.36 years. Ventricular arrhythmias were found in 379 patients (2.6%), 26 patients were found to have premature atrial contractions (PACs) and premature ventricular contractions (PVCs). TdP was found in 49 patients (0.33 %), sudden cardiac death (SCD) was found in five patients and 586 patients were found to have all-cause mortality.ConclusionsAround 6% of patients have risk of QT prolongation when exposed but only 0.3% developed TdP and 2.6% developed ventricular arrhythmias. Risk of developing arrhythmias is higher with concomitant use of multiple QT prolonging drugs.

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Section: Resultsmentioning

confidence: 99%

Impact of Drug Induced Long QT Syndrome: A Systematic Review

et al. 2018

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“…Due to the small sample size, no possible cause was identified. 44 In another study performed in 95 patients acutely admitted to an emergency ward for psychosis in Norway, the proportion of prolonged QTc interval (>450 ms for males and >470 ms for females) decreased from 11.6% at admission to 4.2% at discharge or after 6 weeks of hospitalization at the latest. A positive association was observed between the QTc interval and the agitation score.…”

Section: Discussionmentioning

confidence: 95%

“…The mean QTc values in these studies ranged between 391 ms and 423 ms, 25,32,35,36,38,39,43,48,49 but a higher mean QTc of 451 ms was also reported in one study. 44…”

Section: Discussionmentioning

confidence: 99%

“…30 This prevalence is consistent with the observed rates of QTc prolongation reported in the main studies performed in hospitalized psychiatric patients, with the majority of the values ranging between 2% and 17%, 10,23,[25][26][27][31][32][33][34][35][36][37][38][39][40][41][42][43] but up to 38% in some studies. 33,44 In somatic inpatients, the prevalence of QTc prolongation seems to be higher than in psychiatric inpatients, with rates varying between 22% and 35%. These differences may be explained by older populations and a higher prevalence of cardiovascular comorbidities in somatic inpatients.…”

Section: Discussionmentioning

confidence: 99%

“…The mean QTc values in these studies ranged between 391 ms and 423 ms, 25,32,35,36,38,39,43,48,49 but a higher mean QTc of 451 ms was also reported in one study. 44 Comparison across studies is limited due to different factors such as the heterogeneity in cut-off values used for the definition of QTc prolongation (421-480 ms), study designs, characteristics of patients (inclusion and exclusion criteria, gender, age, ethnic origin, comorbidities), drugs prescribed (first-or second-generation antipsychotics, doses, polymedications), and QT correction methods (Bazett, Fridericia or nomogram), which could explain the large range of values reported.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of ECG abnormalities and risk factors for QTc interval prolongation in hospitalized psychiatric patients

Ansermot

Bochatay

Schlapfer

et al. 2019

Therapeutic Advances in Psychopharmacology

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Background: Psychiatric patients are at risk of cardiovascular diseases, and many psychotropic drugs can prolong QTc interval. Requirements for electrocardiogram (ECG) monitoring have been set up in our psychiatric university hospital. The objective of this study was to determine the proportion of adult patients who had an ECG during their hospitalization, the prevalence of ECG abnormalities, the evolution of the QTc after admission, and the risk factors for QTc prolongation. Methods: Retrospective analysis of ECGs and clinical data of all patients with a complete hospitalization in 2015. Assessment of the influence of covariates on QTc using linear mixed-effects models. Results: At least one ECG ( n = 600) was performed during 37.6% of the stays ( n = 1198) and in 45.5% of the patients ( n = 871). Among the patients with an ECG, 17.9% had significant ECG abnormalities, including 7.6% with a prolonged QTc. QTc measured at admission and during hospitalization did not change significantly ( n = 46, 419.4 ± 29.7 ms, 417.2 ± 27.6 ms, p = 0.71). In the multivariate model (292 patients, 357 ECGs), the covariates significantly associated with the QTc were gender (+15.9 ms if female, p < 0.0001), age (+0.4 ms/year, p = 0.0001), triglyceride levels (+5.7 ms/mmol/l, p = 0.005), and drugs with known risk of torsades de pointes (+6.2 ms if ⩾1 drug, p = 0.028). Conclusions: The prevalence of hospitalized psychiatric patients with an abnormal ECG indicates that ECGs should be performed systematically in this population. Prescription of psychotropic drugs should be done cautiously, particularly in patients with QTc prolongation risk factors.

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Electrocardiogram abnormalities and associated factors among psychiatric patients attending follow up at Jimma Medical Center Psychiatry Clinic, Jimma, Ethiopia: an institution-based cross-sectional study

Girma

Wondie

Debebe

et al. 2023

BMC Cardiovasc Disord

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Background Psychiatric patients have two to three-fold higher risk of cardiovascular morbidity and mortality as compared to the general population. Despite the high rate of cardiovascular disease, about 80% of patients with psychiatric disorders have fewer opportunities for cardiovascular disease screening. Early detection of subclinical cardiovascular disease using an electrocardiogram can improve the clinical outcomes of these patients. However, in Ethiopia, no previous study had been conducted on electrocardiogram abnormalities and associated factors among psychiatric patients. Hence, this study aimed to assess the electrocardiogram abnormalities and associated factors among psychiatric patients attending follow-up at Jimma Medical Center, Jimma, Ethiopia. Methods An institution-based cross-sectional study was carried out among psychiatric patients attending Jimma Medical Center Psychiatry Clinic from October 14 to December 10, 2021. An interviewer-administered structured questionnaire was used to collect socio-demographic data, behavioral factors, disease-related and medication-related data. Anthropometry and blood pressure were measured following the standard protocols. A resting 12 lead ECG was recorded according to the standard recording protocol of the Minnesota code. Data were entered into Epi data version 4.6 and exported to SPSS version 25. Results of the descriptive analysis were summarized by frequencies, means, and proportions, and presented by using tables and figures. Bivariable and multivariable logistic regressions were performed. p value < 0.05 was considered statistically significant. Result A total of 315 psychiatric patients were included in the present study. The mean age (SD) of the respondents was 36.27 ± 10.85 years. ECG abnormalities were identified among 191 (60.6%) respondents. Age older than 40 years [AOR = 3.31: 95% CI 1.58–6.89], treatment with antipsychotics [AOR = 4.16: 95% CI 1.25–13.79], polytherapy [AOR = 3.13: 95% CI 1.15–8.62], having schizophrenia [AOR = 3.11: 95% CI 1.20–8.11], and illness duration of > 10 years [AOR = 4.25: 95% CI 1.72–10.49] were significantly associated with ECG abnormalities. Conclusions In the present study, six out of ten respondents had ECG abnormalities. Age of the respondents, treatment with antipsychotics, having schizophrenia, polytherapy and illness duration of > 10 years were significant predictors of ECG abnormalities. Routine ECG investigation should be performed in the psychiatry treatment setting and further studies are recommended to delineate factors affecting ECG abnormalities.

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Prevalence of QTc interval changes in acute psychiatric care: A cross-sectional study

Abstract: Pro-arrhythmic changes as reflected in QTc prolongation and QTc dispersion in electrocardiograms are common in patients admitted in psychiatric wards irrespective of type of therapy and should be screened and followed by serial electrocardiograms to minimize untoward cardiac outcomes.

Cited by 3 publications

References 31 publications

Impact of Drug Induced Long QT Syndrome: A Systematic Review

Impact of Drug Induced Long QT Syndrome: A Systematic Review

Prevalence of ECG abnormalities and risk factors for QTc interval prolongation in hospitalized psychiatric patients

Electrocardiogram abnormalities and associated factors among psychiatric patients attending follow up at Jimma Medical Center Psychiatry Clinic, Jimma, Ethiopia: an institution-based cross-sectional study

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