QTc interval prolongation in critically ill patients: Prevalence, risk factors and associated medications.
<h4>Purpose</h4>To investigate the prevalence and risk factors of acquired long QT syndrome (LQTS) on admission to a general Intensive Care Unit (ICU), and to assess the risk of LQTS associated with prescribed medications.<h4>Methods</h4>Prospective observational, cross-secti...
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| _version_ | 1850079009323352064 |
|---|---|
| author | Flávia Medeiros Fernandes Eliane Pereira Silva Rand Randall Martins Antonio Gouveia Oliveira |
| author_facet | Flávia Medeiros Fernandes Eliane Pereira Silva Rand Randall Martins Antonio Gouveia Oliveira |
| author_sort | Flávia Medeiros Fernandes |
| collection | DOAJ |
| description | <h4>Purpose</h4>To investigate the prevalence and risk factors of acquired long QT syndrome (LQTS) on admission to a general Intensive Care Unit (ICU), and to assess the risk of LQTS associated with prescribed medications.<h4>Methods</h4>Prospective observational, cross-sectional study approved by the Institutional Review Board. Between May 2014 and July 2016, 412 patients >18 years-old consecutively admitted to the ICU of a university hospital were included. LQTS was defined as a QT interval on the admission electrocardiogram corrected using Bazett's formula (QTc) >460 ms for men and >470 ms for women. All medications administered within 24 hours before admission were recorded. Logistic regression was used.<h4>Results</h4>LQTS prevalence was 27.9%. In LQTS patients, 70.4% had ≥ 1 LQTS-inducing drug prescribed in the 24 hours prior to ICU admission versus 70.4% in non-LQTS patients (p = 0.99). Bradycardia and Charlson morbidity index score are independent risk factors for LQTS. Haloperidol (OR 4.416), amiodarone (OR 2.509) and furosemide (OR 1.895) were associated with LQTS, as well as another drug not yet described, namely clopidogrel (OR 2.241).<h4>Conclusions</h4>The LQTS is highly prevalent in critically ill patients, ICU patients are often admitted with LQTS-inducing medications, and patients with slow heart rate or with high Charlson comorbidity index should be evaluated for LQTS. |
| format | Article |
| id | doaj-art-bc54a3f23ee94437a6f626bc5e8526c2 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-bc54a3f23ee94437a6f626bc5e8526c22025-08-20T02:45:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01136e019902810.1371/journal.pone.0199028QTc interval prolongation in critically ill patients: Prevalence, risk factors and associated medications.Flávia Medeiros FernandesEliane Pereira SilvaRand Randall MartinsAntonio Gouveia Oliveira<h4>Purpose</h4>To investigate the prevalence and risk factors of acquired long QT syndrome (LQTS) on admission to a general Intensive Care Unit (ICU), and to assess the risk of LQTS associated with prescribed medications.<h4>Methods</h4>Prospective observational, cross-sectional study approved by the Institutional Review Board. Between May 2014 and July 2016, 412 patients >18 years-old consecutively admitted to the ICU of a university hospital were included. LQTS was defined as a QT interval on the admission electrocardiogram corrected using Bazett's formula (QTc) >460 ms for men and >470 ms for women. All medications administered within 24 hours before admission were recorded. Logistic regression was used.<h4>Results</h4>LQTS prevalence was 27.9%. In LQTS patients, 70.4% had ≥ 1 LQTS-inducing drug prescribed in the 24 hours prior to ICU admission versus 70.4% in non-LQTS patients (p = 0.99). Bradycardia and Charlson morbidity index score are independent risk factors for LQTS. Haloperidol (OR 4.416), amiodarone (OR 2.509) and furosemide (OR 1.895) were associated with LQTS, as well as another drug not yet described, namely clopidogrel (OR 2.241).<h4>Conclusions</h4>The LQTS is highly prevalent in critically ill patients, ICU patients are often admitted with LQTS-inducing medications, and patients with slow heart rate or with high Charlson comorbidity index should be evaluated for LQTS.https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0199028/1/pone.0199028.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210216%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210216T095355Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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 |
| spellingShingle | Flávia Medeiros Fernandes Eliane Pereira Silva Rand Randall Martins Antonio Gouveia Oliveira QTc interval prolongation in critically ill patients: Prevalence, risk factors and associated medications. PLoS ONE |
| title | QTc interval prolongation in critically ill patients: Prevalence, risk factors and associated medications. |
| title_full | QTc interval prolongation in critically ill patients: Prevalence, risk factors and associated medications. |
| title_fullStr | QTc interval prolongation in critically ill patients: Prevalence, risk factors and associated medications. |
| title_full_unstemmed | QTc interval prolongation in critically ill patients: Prevalence, risk factors and associated medications. |
| title_short | QTc interval prolongation in critically ill patients: Prevalence, risk factors and associated medications. |
| title_sort | qtc interval prolongation in critically ill patients prevalence risk factors and associated medications |
| url | https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0199028/1/pone.0199028.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210216%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210216T095355Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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 |
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