QT延长预测所有原因的死亡率高于和超出了经过验证的风险得分
Selçuk Adabag1, Amy Gravely2, Sharma Kattel1
1Division of Cardiology, Minneapolis VA Health Care System, Minneapolis, MN, United States of America; Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America.
Journal of electrocardiology
|December 31, 2023
概括
QT延长独立地预测死亡率,即使考虑到护理评估需求 (CAN) 评分. 这一发现突显了心电图 (ECG) 发现在评估患者风险方面的预后价值.
科学领域:
- 心脏病学 心脏病学
- 临床研究 临床研究
- 公共卫生 公共卫生
背景情况:
- 电心电图 (ECG) 上的QT延长与危及生命的心律失常和心脏突然死亡有关.
- 以前的研究将QT间隔与全因死亡率联系在一起,但潜在的混因素仍然存在.
- 在已确定的死亡风险得分之外,QT间隔的独立预后值尚不清楚.
研究的目的:
- 为了确定心电图上的QT间隔是否独立地预测死亡率.
- 在对验证的护理评估需求 (CAN) 评分进行调整后,评估 QT 间隔的预后值.
主要方法:
- 从明尼阿波利斯VA (2012-2016) 进行了31,201名带心电图的门诊患者的回顾性队列研究.
- 排除标准包括特定的心室速率和QRS持续时间.
- 使用Bazett的公式纠正了QT间隔 (QTc);在心电图后一周内获得了CAN分数.
主要成果:
- 1.4%的患者QTc≥500毫秒,5.8%的患者QTc为470-500毫秒,92.9%的患者QTc<470毫秒.
- 较长的QTc间隔与较高的1年和5年死亡率显著相关 (p < 0.0001).
- 对CAN得分和预测1年死亡率的QTc的综合C指数为0.837.
结论:
- QT延长是所有原因死亡率的独立预测指标.
- QT 间隔提供了超出已验证的死亡风险评分 (如 CAN 评分) 的预后信息.
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