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Liu W, Shao R, Zhang S, Jin L, Liu R, Chen P, Hu J, Ma H, Wu B, Liang W, Luo X, Li J, Chen W, Xiong N, He B. Characteristics, predictors and outcomes of new-onset QT prolongation in sepsis: a multicenter retrospective study. Crit Care 2024; 28:115. [PMID: 38594724 PMCID: PMC11003155 DOI: 10.1186/s13054-024-04879-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/17/2024] [Indexed: 04/11/2024] Open
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.
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Affiliation(s)
- Weizhuo Liu
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, 241 Huaihaixi Road, Shanghai, 200030, China
- Centre for Cardiopulmonary Translational Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Rongjiao Shao
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, 241 Huaihaixi Road, Shanghai, 200030, China
- Centre for Cardiopulmonary Translational Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shen Zhang
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, 241 Huaihaixi Road, Shanghai, 200030, China
| | - Lei Jin
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, 241 Huaihaixi Road, Shanghai, 200030, China
| | - Rongchen Liu
- Department of Cardiology, Huashan Hospital Fudan University, 12 Wulumuqizhong Road, Shanghai, 200030, China
| | - Peidong Chen
- Department of Infectious Diseases, Jing'an District Central Hospital of Shanghai, Fudan University, Shanghai, China
| | - Jintao Hu
- Department of Cardiology, People's Hospital of Qiubei, Putan Road in Jinping Town, Qiubei, 663200, Yunnan, China
| | - Haocheng Ma
- Department of Cardiology, People's Hospital of Qiubei, Putan Road in Jinping Town, Qiubei, 663200, Yunnan, China
- Department of Cardiology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Bangwei Wu
- Department of Cardiology, Huashan Hospital Fudan University, 12 Wulumuqizhong Road, Shanghai, 200030, China
| | - Weiguo Liang
- Department of Cardiology, Huashan Hospital Fudan University, 12 Wulumuqizhong Road, Shanghai, 200030, China
| | - Xinping Luo
- Department of Cardiology, Huashan Hospital Fudan University, 12 Wulumuqizhong Road, Shanghai, 200030, China
| | - Jian Li
- Department of Cardiology, Huashan Hospital Fudan University, 12 Wulumuqizhong Road, Shanghai, 200030, China
| | - Weiming Chen
- Department of Cardiology, People's Hospital of Qiubei, Putan Road in Jinping Town, Qiubei, 663200, Yunnan, China.
| | - Nanqing Xiong
- Department of Cardiology, Huashan Hospital Fudan University, 12 Wulumuqizhong Road, Shanghai, 200030, China.
| | - Bin He
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, 241 Huaihaixi Road, Shanghai, 200030, China.
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