The following is a summary of “Characteristics, predictors, and outcomes of new-onset QT prolongation in sepsis: a multicenter retrospective study,” published in the April 2024 issue of Critical Care by Liu al.
Researchers conducted a retrospective study investigating the association between QT prolongation and myocardial injury in patients with sepsis.
They conducted a multicenter retrospective cohort study to explore the clinical features and predictors of new-onset QT prolongation in sepsis and its impact on outcomes. Electrocardiographic and clinical data were gathered from patients with sepsis across four centers, excluding those influenced by QT-prolonging medications or electrolyte imbalances. Clinical outcomes were compared between patients with and without QT prolongation (QTc > 450 ms). Multivariate analysis determined if QT prolongation independently predicted 30-day mortality. Factors predicting QT prolongation in sepsis were also analyzed.
The results showed that new-onset QT prolongation was present in 235 out of 1,024 (22.9%) patients. The majority exhibited a pattern resembling type 1 long QT syndrome. Patients with QT prolongation experienced higher 30-day in-hospital mortality (P<0.001), along with increased occurrences of tachyarrhythmias such as paroxysmal atrial fibrillation or tachycardia (P<0.001) and ventricular arrhythmia (P<0.001) during hospitalization. QT prolongation independently predicted 30-day mortality (P=0.044) according to multivariate analysis. History of coronary artery disease (P=0.001), septic shock (P=0.008), acute respiratory (P<0.001), heart (P=0.021), and renal dysfunction (P=0.013) were identified as independent predictors of QT prolongation in sepsis.
Investigators concluded that new-onset QT prolongation in sepsis predicted increased mortality and arrhythmias and was, in turn, predicted by disease severity and organ dysfunction.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04879-2