OBJECTIVE: The aim of this study was to investigate if the electrocardiographic (ECG) abnormalities assessed early in the emergency department (ED) are associated with the in-hospital mortality of the patients with spontaneous subarachnoid hemorrhage (SAH). METHODS: We studied prospectively a cohort of 222 adult patients with spontaneous SAH in an ED. A 12-lead ECG was performed for these patients in the ED. The patients were stratified into nonsurvivors and survivors based on the in-hospital mortality. The clinical characteristics, heart rate, corrected QT interval (QTc) and 7 predefined morphologic abnormalities were compared between these 2 groups of patients. RESULTS: Compared with the survivors (n=178), the nonsurvivors (n=44) had significantly slower heart rate (75±23 vs 83±16, P=.018) and more prolonged QTc (492±58 vs 458±40, P=.001). There were significantly higher frequency of occurrence of ECG morphologic abnormalities (66% vs 37%, P=.001) and nonspecific ST- or T-wave changes (NSSTTCs; 32% vs 12%, P=.015) in the nonsurvivors compared with those in the survivors. Multiple logistic regression model identified QTc (odds ratio, 1.0; 95% confidence interval, 1.0-1.0; P=.005) and NSSTTC (odds ratio, 3.3; 95% confidence interval, 1.0-10.7; P=.047) as the significant ECG variables associated with in-hospital mortality. CONCLUSIONS: The occurrence of NSSTTC and prolonged QTc assessed early in the ED are independently associated with the in-hospital mortality in adult patients with spontaneous SAH.
OBJECTIVE: The aim of this study was to investigate if the electrocardiographic (ECG) abnormalities assessed early in the emergency department (ED) are associated with the in-hospital mortality of the patients with spontaneous subarachnoid hemorrhage (SAH). METHODS: We studied prospectively a cohort of 222 adult patients with spontaneous SAH in an ED. A 12-lead ECG was performed for these patients in the ED. The patients were stratified into nonsurvivors and survivors based on the in-hospital mortality. The clinical characteristics, heart rate, corrected QT interval (QTc) and 7 predefined morphologic abnormalities were compared between these 2 groups of patients. RESULTS: Compared with the survivors (n=178), the nonsurvivors (n=44) had significantly slower heart rate (75±23 vs 83±16, P=.018) and more prolonged QTc (492±58 vs 458±40, P=.001). There were significantly higher frequency of occurrence of ECG morphologic abnormalities (66% vs 37%, P=.001) and nonspecific ST- or T-wave changes (NSSTTCs; 32% vs 12%, P=.015) in the nonsurvivors compared with those in the survivors. Multiple logistic regression model identified QTc (odds ratio, 1.0; 95% confidence interval, 1.0-1.0; P=.005) and NSSTTC (odds ratio, 3.3; 95% confidence interval, 1.0-10.7; P=.047) as the significant ECG variables associated with in-hospital mortality. CONCLUSIONS: The occurrence of NSSTTC and prolonged QTc assessed early in the ED are independently associated with the in-hospital mortality in adult patients with spontaneous SAH.
Authors: Ju Young Hong; Je Sung You; Min Joung Kim; Hye Sun Lee; Yoo Seok Park; Sung Phil Chung; Incheol Park Journal: BMJ Open Date: 2019-02-20 Impact factor: 2.692