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急诊科因晕厥就诊患者的校正 QT 间期延长与死亡率的关系。

Relationship between a Prolonged Corrected QT Interval and Mortality in Patients Presenting with Syncope at the Emergency Department.

机构信息

Department of Emergency Medicine, Izmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey.

Department of Emergency Medicine, Republic of Turkey, The Ministry of Health Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.

出版信息

Biomed Res Int. 2021 Nov 24;2021:5441670. doi: 10.1155/2021/5441670. eCollection 2021.

Abstract

BACKGROUND

Syncope is a common symptom in emergency department patients. Among various etiological factors, cardiac causes have the highest risk of mortality. The corrected QT interval is considered an independent predictor of mortality for many diseases.

OBJECTIVES

Analyze QT interval analysis of patients presenting to the emergency department with syncope.

METHODS

In this prospective observational study, patients who presented to the emergency department with syncope between January 1, 2018, and January 1, 2019 were included.

RESULTS

The median age was 64 (49-78) years, and 58.8% of patients were male. The corrected QT interval (QTc) in patients with coronary artery disease and chronic obstructive pulmonary disease was longer than those without. There was no statistically significant association between hypertension, diabetes, stroke, thyroid disease, and prolonged QTc. Patients who did not survive had significantly prolonged QT intervals. According to ROC analysis, sensitivity of >440.5 ms QTc values in predicting mortality was 86% and specificity was 71% (AUC = 0.815; 95%CI = 0.71 - 0.91; < 0.001).

CONCLUSIONS

Patients admitted to emergency department with syncope and a prolonged QTc are associated with a higher mortality rate and thus can provide us with an important guide for the management of these patients.

摘要

背景

晕厥是急诊科患者的常见症状。在各种病因中,心源性病因的死亡率最高。校正 QT 间期被认为是许多疾病死亡率的独立预测因素。

目的

分析因晕厥到急诊科就诊患者的 QT 间期。

方法

在这项前瞻性观察性研究中,纳入了 2018 年 1 月 1 日至 2019 年 1 月 1 日期间因晕厥到急诊科就诊的患者。

结果

中位年龄为 64(49-78)岁,58.8%的患者为男性。患有冠状动脉疾病和慢性阻塞性肺疾病的患者的校正 QT 间期(QTc)长于无此类疾病的患者。高血压、糖尿病、中风、甲状腺疾病与 QTc 延长之间无统计学显著关联。未存活的患者 QT 间期显著延长。根据 ROC 分析,>440.5 ms QTc 值预测死亡率的敏感性为 86%,特异性为 71%(AUC=0.815;95%CI=0.71-0.91;<0.001)。

结论

因晕厥且 QTc 延长而到急诊科就诊的患者死亡率较高,因此可以为这些患者的治疗提供重要指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22c/8635855/1b2a926993a7/BMRI2021-5441670.001.jpg

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