Department of Cardiology, Faculty of Medicine, Selçuk University, Konya, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Jul;27(14):6662-6670. doi: 10.26355/eurrev_202307_33136.
This study aimed to determine the correlation between selected electrocardiogram (ECG) parameters (recorded at admission) and mortality in non-cardiac, non-COVID-19 intensive care unit (ICU) patients, and to determine the sensitivity and specificity of a novel admission ECG score (AD-ECG) for predicting mortality. Additionally, the sensitivity and specificity of the AD-ECG and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores for predicting ICU mortality were compared.
Clinical and laboratory data, and ECG parameters were compared between ICU survivors and non-survivors. ECG parameters (the QTc and Tpe intervals, and the Tpe/QT and Tpe/QTc ratios) and pulse pressure at ICU admission (baseline) were used to calculate the AD-ECG score. Cut-off values for ECG parameters, pulse pressure, and AD-ECG and APACHE II scores were calculated. The sensitivity and specificity of the APACHE II and AD-ECG scores were determined.
The study included 167 patients. Mortality was higher in the patients with comorbidities, mechanical ventilation, and length of ICU stay (p < 0.05). The QTc and Tpe intervals, and the TPe/QT and TPe/QTc ratios differed significantly between the survivors and non-survivors (p < 0.05). The sensitivity and specificity of the AD-ECG score were similar to those of the APACHE II score. When pulse pressure, and the QTc and Tpe intervals were added to APACHE II, the sensitivity of the APACHE II score increased from 78.9% to 85.5%, and its specificity increased from 75% to 86.8%.
A novel admission ECG score (AD-ECG) based on ECG parameters (the QTc and Tpe intervals, and the Tpe/QT and Tpe/QTc ratios) and pulse pressure has similar sensitivity and specificity as the APACHE II score for predicting non-cardiac ICU mortality. Adding pulse pressure, and the QTc and Tpe intervals increases the sensitivity and specificity of the APACHE II score; however, as the present study included non-cardiac patients only, additional larger-scale studies are needed to obtain more precise results.
本研究旨在确定非心脏、非 COVID-19 重症监护病房（ICU）患者入院时某些心电图（ECG）参数（入院时记录）与死亡率之间的相关性，并确定一种新型入院 ECG 评分（AD-ECG）预测死亡率的敏感性和特异性。此外，还比较了 AD-ECG 和急性生理学和慢性健康评估 II（APACHE II）评分预测 ICU 死亡率的敏感性和特异性。
比较 ICU 幸存者和非幸存者的临床和实验室数据以及 ECG 参数。入院时的 ECG 参数（QTc 和 Tpe 间期，Tpe/QT 和 Tpe/QTc 比值）和脉搏压用于计算 AD-ECG 评分。计算 ECG 参数、脉搏压、AD-ECG 和 APACHE II 评分的截断值。确定 APACHE II 和 AD-ECG 评分的敏感性和特异性。
本研究共纳入 167 例患者。患有合并症、机械通气和 ICU 住院时间较长的患者死亡率较高（p < 0.05）。幸存者和非幸存者之间 QTc 和 Tpe 间期以及 TPe/QT 和 TPe/QTc 比值差异有统计学意义（p < 0.05）。AD-ECG 评分的敏感性和特异性与 APACHE II 评分相似。当将脉搏压和 QTc 和 Tpe 间期添加到 APACHE II 中时，APACHE II 评分的敏感性从 78.9%增加到 85.5%，特异性从 75%增加到 86.8%。
一种基于 ECG 参数（QTc 和 Tpe 间期以及 Tpe/QT 和 Tpe/QTc 比值）和脉搏压的新型入院 ECG 评分（AD-ECG）预测非心脏 ICU 死亡率的敏感性和特异性与 APACHE II 评分相似。添加脉搏压和 QTc 和 Tpe 间期可提高 APACHE II 评分的敏感性和特异性；然而，由于本研究仅包括非心脏患者，因此需要进行更多的大规模研究以获得更精确的结果。
