QTc prolongation as a marker of 30-day serious outcomes in older patients with syncope presenting to the Emergency Department.
Am J Emerg Med
; 37(4): 685-689, 2019 04.
Article
em En
| MEDLINE
| ID: mdl-30017687
ABSTRACT
BACKGROUND:
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.METHODS:
This is a secondary analysis of a prospective, observational study at 11 EDs in adults 60â¯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 of <451; 451-470; 471-500, and >500â¯ms. We determined the rate of composite 30-day serious outcomes including ED serious outcomes and 30-day arrhythmias not identified in ED.RESULTS:
The study cohort included 2609 patients. There were 1678 patients (64.3%) that had QTc intervals <451â¯ms; 544 (20.8%) were 451-470â¯ms; 302 (11.6%) were 471-500â¯ms, and 85 (3.3%) had intervals >500â¯ms. Composite 30-day serious outcomes was associated with increasingly prolonged QTc intervals (13.0%, 15.3%, 18.2%, 22.4%, pâ¯=â¯0.01), but this association did not persist in multivariate analysis.CONCLUSIONS:
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Síncope
/
Síndrome do QT Longo
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Eletrocardiografia
/
Sistema de Condução Cardíaco
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article