Farzanegan Behrooz, Hosseinpoor Zeinab, Baniasadi Shadi, Seyyedi Seyyed R, Rajabi Mehdi
Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Indian J Crit Care Med. 2020 Apr;24(4):270-275. doi: 10.5005/jp-journals-10071-23411.
Despite the importance of abnormal QTc interval values in intensive care unit (ICU) patients, there is a paucity of information on this topic. The current study was designed to identify the incidence and predictors of QTc prolongation in medical (M), surgical (S), and emergency (E) ICUs.
A prospective observational study was conducted for 6 months. Patients more than 18 years old who admitted to MICU, SICU, and EICU were included in the study. Electrocardiogram (ECG) was taken on day 1, 3, and 5 of ICU admission. The QTc intervals >460 ms in male and >470 ms in female and increased >60 ms above baseline were considered QTc prolongation. Comparative analysis was done between two groups of patients (normal vs prolonged QTc). Logistic regression models were carried out to determine the predictors of QTc prolongation.
Incidence of QTc prolongation was 6.5, 9.8, and 15.7% on day 1, 3, and 5 of ICU admission, respectively. On day 1, the history of alcohol addiction and the reason of ICU admission were associated with a prolonged QTc. A significant association was demonstrated between administration of azithromycin and QTc prolongation on day 3. High serum creatinine and hospitalization in EICU were predictors of QTc prolongation on day 5 of ICU admission.
The QTc prolongation is relatively common among patients admitted to ICUs and its incidence increases with increasing length of hospital stay. Predictors of QTc prolongation may be affected by the duration of ICU admission. Physicians should consider these predictors particularly before prescribing QTc-prolonging drugs.
Farzanegan B, Hosseinpoor Z, Baniasadi S, Seyyedi SR, Rajabi M. An Observational Study of QTc Prolongation in Critically Ill Patients: Identification of Incidence and Predictors. Indian J Crit Care Med 2020;24(4):270-275.
尽管重症监护病房（ICU）患者的QTc间期异常值很重要，但关于这一主题的信息却很少。本研究旨在确定内科（M）、外科（S）和急诊（E）ICU中QTc延长的发生率及预测因素。
进行了一项为期6个月的前瞻性观察研究。纳入入住MICU、SICU和EICU的18岁以上患者。在入住ICU的第1天、第3天和第5天进行心电图（ECG）检查。男性QTc间期>460毫秒、女性>470毫秒且较基线增加>60毫秒被视为QTc延长。对两组患者（QTc正常与延长）进行比较分析。采用逻辑回归模型确定QTc延长的预测因素。
入住ICU第1天、第3天和第5天的QTc延长发生率分别为6.5%、9.8%和15.7%。在第1天，酒精成瘾史和入住ICU的原因与QTc延长有关。在第3天，阿奇霉素的使用与QTc延长之间存在显著关联。高血清肌酐和在EICU住院是入住ICU第5天QTc延长的预测因素。
QTc延长在入住ICU的患者中相对常见，其发生率随住院时间延长而增加。QTc延长的预测因素可能受入住ICU时间的影响。医生在开具可延长QTc的药物之前应特别考虑这些预测因素。
Farzanegan B, Hosseinpoor Z, Baniasadi S, Seyyedi SR, Rajabi M. 危重症患者QTc延长的观察性研究：发生率及预测因素的确定。《印度重症监护医学杂志》2020；24(4):270 - 275。
