High prevalence of corrected QT interval prolongation in acutely ill patients is associated with mortality: Results of the QT in Practice (QTIP) Study*.
OBJECTIVE: : To test the potential value of more frequent QT interval measurement in hospitalized patients. DESIGN: : We performed a prospective, observational study. SETTING: : All adult intensive care unit and progressive care unit beds of a university medical center. PATIENTS: : All patients admi...
| Publicado en: | Critical Care Medicine Vol. 40; no. 2; pp. 394 - 400 |
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| Autores principales: | , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Feb2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=108220600&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 108220600 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00903493 04O jtl: Critical Care Medicine issn: 00903493 maglogo: N pubinfo: dt: Feb2012 vid: 40 iid: 2 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 108220600 108220600 2011430499 10.1097/ccm.0b013e318232db4a NLM22001585 108220600 ppf: 394 ppct: 6 formats: tig: atl: High prevalence of corrected QT interval prolongation in acutely ill patients is associated with mortality: Results of the QT in Practice (QTIP) Study*. aug: au: Pickham D Helfenbein E Shinn JA Chan G Funk M Weinacker A Liu JN Drew BJ affil: From the Department of Physiological Nursing (DP, GC, JNL, BJD), University of California San Francisco, San Francisco, CA; Advanced Algorithm Research Center (EH), Philips Healthcare, San Jose, CA; Stanford University Medical Center (JAS, AW), Stanford, CA; School of Nursing (MF), Yale University, New Haven, CT. sug: subj: Intensive Care Units Long QT Syndrome Diagnosis Long QT Syndrome Epidemiology Monitoring, Physiologic Methods Torsades de Pointes Diagnosis Torsades de Pointes Epidemiology Academic Medical Centers Adult Cause of Death Prospective Studies Confidence Intervals Critical Care Methods Critical Illness Mortality Critical Illness Therapy Electrocardiography Methods Female Heart Arrest Mortality Hospital Mortality Human Long QT Syndrome Therapy Male Odds Ratio Clinical Information Systems Predictive Value of Tests Prevalence Prognosis Risk Assessment Severity of Illness Indices Survival Torsades de Pointes Therapy Adult: 19-44 years Female Male ab: OBJECTIVE: : To test the potential value of more frequent QT interval measurement in hospitalized patients. DESIGN: : We performed a prospective, observational study. SETTING: : All adult intensive care unit and progressive care unit beds of a university medical center. PATIENTS: : All patients admitted to one of six critical care units over a 2-month period were included in analyses. INTERVENTIONS: : All critical care beds (n = 154) were upgraded to a continuous QT monitoring system (Philips Healthcare). MEASUREMENTS AND MAIN RESULTS: : QT data were extracted from the bedside monitors for offline analysis. A corrected QT interval >500 msecs was considered prolonged. Episodes of QT prolongation were manually over-read. Electrocardiogram data (67,648 hrs, mean 65 hrs/patient) were obtained. QT prolongation was present in 24%. There were 16 cardiac arrests, with one resulting from Torsade de Pointes (6%). Predictors of QT prolongation were female sex, QT-prolonging drugs, hypokalemia, hypocalcemia, hyperglycemia, high creatinine, history of stroke, and hypothyroidism. Patients with QT prolongation had longer hospitalization (276 hrs vs. 132 hrs, p < .0005) and had three times the odds for all-cause in-hospital mortality compared to patients without QT prolongation (odds ratio 2.99 95% confidence interval 1.1-8.1). CONCLUSIONS: : We find QT prolongation to be common (24%), with Torsade de Pointes representing 6% of in-hospital cardiac arrests. Predictors of QT prolongation in the acutely ill population are similar to those previously identified in ambulatory populations. Acutely ill patients with QT prolongation have longer lengths of hospitalization and nearly three times the odds for mortality then those without QT prolongation. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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