University of California - Davis, Department of Emergency Medicine, Sacramento, CA, United States; VA Northern California Health Care System, Mather, CA, United States.
University of California - Davis, Department of Emergency Medicine, Sacramento, CA, United States.
Am J Emerg Med. 2018 May;36(5):777-779. doi: 10.1016/j.ajem.2017.10.012. Epub 2017 Oct 7.
Prolongation of the QT interval is a well-recognized complication associated with many commonly used medications. Emergency Department monitoring of the corrected QT (QTc) both before and after medication administration is typically performed using the 12‑lead electrocardiogram (ECG). The purpose of this study is to compare the QTc reported on the 12‑lead ECG to that reported by single brand of bedside monitor.
A convenience sample of emergency department patients over the age of 18 undergoing bedside monitoring and who had an ECG ordered by their treating physician were enrolled. These patients underwent simultaneous ECG and monitor QTc calculation. The primary outcome of interest was the correlation between the monitor and ECG QTc. Secondary outcomes included ability of each method to identify patients with a QTc >500ms and the ability of each method to identify patients with a QTc <450ms.
A total of 125 patients had simultaneous ECG and monitor QTc measurements recorded. There was moderate correlation between the monitor and ECG QTc (Pearson's correlation coefficient=0.55). The median difference between the ECG QTc and the monitor QTc (ECG QTc minus monitor QTc) was -7ms (IQR -23 to 11ms).
We found that there was moderate correlation between the QTc reported on the 12 lead ECG and that reported by the bedside monitor. This correlation is not strong enough to support the use of the bedside monitor as a substitute for the 12‑lead ECG when evaluating a patient's QTc.
QT 间期延长是与许多常用药物相关的一种公认并发症。在给药前后，通常使用 12 导联心电图（ECG）对急诊科的校正 QT（QTc）进行监测。本研究的目的是比较 12 导联 ECG 报告的 QTc 与床边监护仪单一品牌报告的 QTc。
选取在急诊科接受床边监测且其主治医生开具 ECG 检查的 18 岁以上患者作为便利样本。这些患者同时进行 ECG 和监护仪 QTc 计算。主要观察指标是监护仪和 ECG QTc 之间的相关性。次要观察指标包括每种方法识别 QTc>500ms 患者的能力以及每种方法识别 QTc<450ms 患者的能力。
共有 125 例患者同时记录了 ECG 和监护仪 QTc 测量值。监护仪和 ECG QTc 之间存在中度相关性（Pearson 相关系数=0.55）。ECG QTc 与监护仪 QTc 之间的中位数差异（ECG QTc 减去监护仪 QTc）为-7ms（IQR-23 至 11ms）。
我们发现 12 导联 ECG 报告的 QTc 与床边监护仪报告的 QTc 之间存在中度相关性。这种相关性不够强，不能支持在评估患者的 QTc 时将床边监护仪作为 12 导联 ECG 的替代品。
