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Traumatic subarachnoid hemorrhage and QTc prolongation
Bryan R Collier1, S Lee Miller, Gary S Kramer
1Department of Surgery, Temple University/Conemaugh Memorial Medical Center, Johnstown, Pennsylvania 15905, USA.
Journal of Neurosurgical Anesthesiology
|June 24, 2004
Summary
Traumatic subarachnoid hemorrhage (tSAH) frequently causes a prolonged corrected QT interval (QTc). This QTc prolongation worsens with increasing tSAH severity, indicating a potential acquired QTc syndrome.
Area of Science:
- Neurology
- Cardiology
- Trauma Care
Background:
- Spontaneous subarachnoid hemorrhage (SAH) is known to cause corrected QT interval (QTc) prolongation in a significant portion of patients.
- The occurrence and extent of QTc prolongation following traumatic subarachnoid hemorrhage (tSAH) remain largely uninvestigated.
Purpose of the Study:
- To determine if QTc prolongation occurs in patients with tSAH.
- To assess the relationship between tSAH severity and the degree of QTc prolongation.
Main Methods:
- A retrospective review of 104 consecutive tSAH patients admitted to a Level II trauma center.
- QTc intervals were calculated on post-trauma days 0, 1, and 3.
- Cranial CT scans were graded for tSAH severity using a validated scale, and QTc intervals were compared based on severity.
Main Results:
- QTc prolongation was observed in 67% of patients with tSAH.
- Mean QTc intervals were 470 ms (PTD0), 467 ms (PTD1), and 465 ms (PTD3).
- A significant positive correlation was found between tSAH severity and QTc prolongation (Pearson's r = 0.855, P = 0.003).
Conclusions:
- Traumatic subarachnoid hemorrhage is a common cause of acquired prolonged QTc syndrome.
- The severity of tSAH directly correlates with the degree of QTc prolongation.