Hassanian-Moghaddam Hossein, Amiri Hassan, Zamani Nasim, Rahimi Mitra, Shadnia Shahin, Taherkhani Maryam
Toxicological Research Center, Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Karegar Street, Tehran, Iran.
Cardiovasc Toxicol. 2014 Jun;14(2):129-33. doi: 10.1007/s12012-013-9236-9.
We aimed to evaluate the efficacy of QT dispersion (QTD) in determining the outcome of the patients poisoned by cardiotoxic medications and toxins. Patients who referred to our emergency department (ED) due to acute toxicity with any cardiotoxic medication or toxin and were admitted to medical toxicology intensive care unit (MTICU) were enrolled into the study. A questionnaire containing the demographic characteristics, vital signs, laboratory tests, electrocardiographic (ECG) parameters of the first ECG taken on MTICU or ED admission, simplified acute physiology score (SAPS), and acute physiology and chronic health evaluation (APACHE) score was filled for every single patient. QTD was manually calculated. The patients were divided into two groups of survivors and non-survivors and compared. Although QTD was not significantly different between the survivors and non-survivors (P = 0.8), SAPS II and APACHE II score were so. SAPS and APACHE had the highest sensitivity and specificity in determining the patients' mortality, respectively. SAPS had the highest sensitivity, and QTD had the highest specificity in predicting the later development of the complications. SAPS II and APACHE II scoring systems are the best systems for prognostication of death in patients with acute cardiotoxic medication-induced poisonings. QTD can be successfully used for the prediction of complications.
我们旨在评估QT离散度(QTD)在判定心脏毒性药物和毒素中毒患者预后方面的有效性。因急性中毒(由任何心脏毒性药物或毒素所致)前来我院急诊科(ED)就诊并入住中毒医学重症监护病房(MTICU)的患者被纳入本研究。为每位患者填写一份问卷,内容包括人口统计学特征、生命体征、实验室检查、MTICU或ED入院时首次心电图的心电图(ECG)参数、简化急性生理学评分(SAPS)以及急性生理学与慢性健康状况评估(APACHE)评分。QTD通过手工计算得出。患者被分为存活组和非存活组并进行比较。尽管存活组和非存活组之间的QTD无显著差异(P = 0.8),但SAPS II和APACHE II评分有显著差异。SAPS和APACHE在判定患者死亡率方面分别具有最高的敏感性和特异性。SAPS在预测并发症的后期发生方面敏感性最高,而QTD特异性最高。SAPS II和APACHE II评分系统是急性心脏毒性药物所致中毒患者死亡预后评估的最佳系统。QTD可成功用于并发症的预测。