Birda Chhagan Lal, Kumar Susheel, Bhalla Ashish, Sharma Navneet, Kumari Savita
Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Int J Crit Illn Inj Sci. 2018 Jan-Mar;8(1):28-35. doi: 10.4103/IJCIIS.IJCIIS_59_17.
QTc interval is affected by many factors and prolongation of same may have prognostic significance. A significant number of patients admitted in medical emergency are acutely ill, have multiple comorbidities and are on medications, all of these factors might affect QTc interval and prognosis.
Single-center, prospective, observational study was carried out on 279 patients of different illnesses recruited from emergency medical services attached to the Department of Internal Medicine at Postgraduate Institute of Medical Education and Research, Chandigarh, India, a tertiary care hospital.
Out of 279 patients, 95 were found to have prolonged QTc interval with the prevalence of 34.1%. Fifteen patients (5.4%) had markedly prolonged QTc interval (QTc >500 ms). Of various medical conditions, we found statistically significantly higher number of patients of chronic kidney disease ( = 0.047), chronic liver disease ( < 0.001), hemorrhagic cerebrovascular accident ( = 0.026), and heart failure ( = 0.009) with prolonged QTc interval. Among laboratory abnormalities, patients with low hemoglobin ( = 0.032), with deranged renal functions ( = 0.033), and with hypokalemia ( = 0.026) had a greater share of patients with prolonged QTc interval. There was no difference in duration of hospital stay and frequency of hospital mortality between two groups, although, on subgroup analysis, patients with markedly prolonged QTc interval had significantly higher hospital mortality ( = 0.029). The frequency of ventricular tachycardia was also significantly higher in patients with prolonged QTc interval ( = 0.008).
High prevalence of prolonged QTc interval was found in Indian emergency medical patients. There was no difference in hospital mortality though on subgroup analysis, patients with markedly prolonged QTc interval had significantly more episodes of in-hospital ventricular tachycardia and hospital mortality.
QTc间期受多种因素影响，其延长可能具有预后意义。大量入住医疗急救科的患者病情危急，合并多种疾病且正在接受药物治疗，所有这些因素都可能影响QTc间期和预后。
在印度昌迪加尔医学教育与研究研究生院内科附属急救医疗服务中心招募的279例不同疾病患者中进行了单中心、前瞻性观察研究，该中心为一家三级医疗机构。
279例患者中，95例QTc间期延长，患病率为34.1%。15例患者（5.4%）QTc间期显著延长（QTc>500毫秒）。在各种医疗状况中，我们发现慢性肾病患者（P = 0.047）、慢性肝病患者（P<0.001）、出血性脑血管意外患者（P = 0.026）和心力衰竭患者（P = 0.009）中QTc间期延长的患者数量在统计学上显著更多。在实验室异常情况中，血红蛋白水平低的患者（P = 0.032）、肾功能紊乱的患者（P = 0.033）和低钾血症患者（P = 0.026）中QTc间期延长的患者比例更高。两组患者的住院时间和医院死亡率频率没有差异，不过，在亚组分析中，QTc间期显著延长的患者医院死亡率显著更高（P = 0.029）。QTc间期延长的患者室性心动过速的频率也显著更高（P = 0.008）。
在印度急诊患者中发现QTc间期延长的患病率较高。医院死亡率没有差异，不过在亚组分析中，QTc间期显著延长的患者院内室性心动过速发作次数和医院死亡率显著更高。
