QTc prolongation as a marker of 30-day serious outcomes in older patients with syncope presenting to the Emergency Department
| Autor: | Benjamin C. Sun, Jennifer L. White, Anna Marie Chang, Manish N. Shah, Kirk A. Stiffler, Deborah B. Diercks, Daniel K. Nishijima, David H. Adler, Judd E. Hollander, Christopher W. Baugh, Erica Su, Annick N. Yagapen, Robert E. Weiss, Aveh Bastani, Jeffrey M. Caterino, Scott T. Wilber, Alan B. Storrow, Bret A. Nicks, Susan Malveau, Carol L. Clark |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Time Factors Multivariate analysis Risk Assessment QT interval Syncope Electrocardiography 03 medical and health sciences 0302 clinical medicine Older patients Heart Conduction System Predictive Value of Tests Risk Factors medicine Humans Prospective Studies cardiovascular diseases Aged Aged 80 and over biology Bundle branch block business.industry Syncope (genus) 030208 emergency & critical care medicine General Medicine Emergency department Middle Aged biology.organism_classification medicine.disease United States Long QT Syndrome Logistic Models Multivariate Analysis Cohort Emergency Medicine Female Observational study Emergency Service Hospital business |
| Zdroj: | The American Journal of Emergency Medicine. 37:685-689 |
| ISSN: | 0735-6757 |
| DOI: | 10.1016/j.ajem.2018.07.022 |
| Popis: | Syncope is a common chief complaint in the ED, and the electrocardiogram (ECG) is a routine diagnostic tool in the evaluation of syncope. We assessed whether increasingly prolonged QTc intervals are associated with composite 30-day serious outcomes in older adults presenting to the ED with syncope.This is a secondary analysis of a prospective, observational study at 11 EDs in adults 60 years or older who presented with syncope or near syncope. We excluded patients presenting without an ECG, measurement of QTc, non-sinus rhythm, bundle branch block or those without 30-day follow-up. We categorized QTc cutoffs into values of451; 451-470; 471-500, and500 ms. We determined the rate of composite 30-day serious outcomes including ED serious outcomes and 30-day arrhythmias not identified in ED.The study cohort included 2609 patients. There were 1678 patients (64.3%) that had QTc intervals451 ms; 544 (20.8%) were 451-470 ms; 302 (11.6%) were 471-500 ms, and 85 (3.3%) had intervals500 ms. Composite 30-day serious outcomes was associated with increasingly prolonged QTc intervals (13.0%, 15.3%, 18.2%, 22.4%, p = 0.01), but this association did not persist in multivariate analysis.In a cohort of older patients presenting with syncope, increased QTc interval was a marker of but was not independently predictive of composite 30-day serious outcomes. |
| Databáze: | OpenAIRE |
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