Increased fragmented QRS and decreased basophil in earthquake-related post-traumatic stress disorder

Many people died or were injured in two consecutive huge earthquakes in Turkey in February 2023. The earthquakes caused serious psychiatric disorders including post-traumatic stress disorder (PTSD). This study aimed to compare various electrocardiography (ECG) parameters including fragmented QRS (fQRS) and complete blood count (CBC) parameters including basophil to lymphocyte ratio (BLR) of earthquake-exposed with and without post-traumatic stress disorder (PTSD) subjects.

ECG and CBC parameters were obtained from 47 earthquake-exposed with PTSD subjects and 51 earthquake-exposed without PTSD subjects. Additional psychiatric and general medical conditions that might affect ECG and CBC were excluded. The PTSD severity scale (PCL-5) and the Symptom Checklist-90-Revised (SCL-90-R) were used.

Gender, age, education level, marital and smoking status, PTSD history, location at the time of earthquakes, and residence damage were similar between groups (p > 0.05). The SCL-90-R score of the earthquake-exposed with PTSD group was higher than the earthquake-exposed without PTSD group (p < 0.001). The fQRS count (p = 0.041), presence of fQRS (p = 0.024) and frontal QRS-T angle (p = 0.004) were significantly higher in the earthquake-exposed with PTSD group. This significance persisted for frontal QRS-T angle (adjusted p = 0.049) after controlling for the effects of age, gender, smoking status, post-earthquake migration, and body mass index (BMI) as covariance. After controlling for the effect of age, gender, and BMI in the earthquake-exposed with PTSD group, a significant correlation was detected between fQRS count and PCL-5 (r = 0.764, p < 0.001). The area under the ROC curve of basophil count was 0.857 (p < 0.001; 95 % CI (0.779-0.936)). In the binary logistic regression analysis, BLR contributed significantly to the model (p < 0.001).

This study suggests that there may be significant differences between surface ECG and CBC parameters of individuals with and without earthquake-related PTSD.