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Characteristics, predictors and outcomes of new-onset QT prolongation in sepsis: a multicenter retrospective study.


ABSTRACT:

Background

Sepsis-induced myocardial injury is a serious complication of sepsis. QT prolongation is a proarrhythmic state which reflects myocardial injury in a group of heterogeneous disorders. However, the study on the clinical value of QT prolongation in sepsis is limited.

Methods

We aimed to investigate the clinical characteristics and predictors of new-onset QT prolongation in sepsis and its impact on the outcome in a multicenter retrospective cohort study. Electrocardiographic and clinical data were collected from patients with sepsis from the wards and intensive care units of four centers after exclusion of QT-influencing medications and electrolyte abnormalities. Clinical outcomes were compared between patients with and without QT prolongation (QTc > 450 ms). Multivariate analysis was performed to ascertain whether QT prolongation was an independent predictor for 30-day mortality. The factors predicting QT prolongation in sepsis were also analyzed.

Results

New-onset QT prolongation occurred in 235/1024 (22.9%) patients. The majority demonstrated similar pattern as type 1 long QT syndrome. Patients with QT prolongation had a higher 30-day in-hospital mortality (P < 0.001), which was also associated with increased tachyarrhythmias including 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) after 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 independent predictors of QT prolongation in sepsis.

Conclusions

New-onset QT prolongation in sepsis was associated with increased mortality as well as atrial and ventricular arrhythmias, which was predicted by disease severity and organ dysfunction.

SUBMITTER: Liu W 

PROVIDER: S-EPMC11003155 | biostudies-literature | 2024 Apr

REPOSITORIES: biostudies-literature

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Publications

Characteristics, predictors and outcomes of new-onset QT prolongation in sepsis: a multicenter retrospective study.

Liu Weizhuo W   Shao Rongjiao R   Zhang Shen S   Jin Lei L   Liu Rongchen R   Chen Peidong P   Hu Jintao J   Ma Haocheng H   Wu Bangwei B   Liang Weiguo W   Luo Xinping X   Li Jian J   Chen Weiming W   Xiong Nanqing N   He Bin B  

Critical care (London, England) 20240409 1


<h4>Background</h4>Sepsis-induced myocardial injury is a serious complication of sepsis. QT prolongation is a proarrhythmic state which reflects myocardial injury in a group of heterogeneous disorders. However, the study on the clinical value of QT prolongation in sepsis is limited.<h4>Methods</h4>We aimed to investigate the clinical characteristics and predictors of new-onset QT prolongation in sepsis and its impact on the outcome in a multicenter retrospective cohort study. Electrocardiographi  ...[more]

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