NDLI: The 12-lead electrocardiogram in patients with subarachnoid hemorrhage: early risk prognostication.

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The 12-lead electrocardiogram in patients with subarachnoid hemorrhage: early risk prognostication.

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The 12-lead electrocardiogram in patients with subarachnoid hemorrhage: early risk prognostication.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Huang, Chien-Cheng Huang, Chi-Hung Kuo, Hung-Yi Chan, Chia-Meng Chen, Jiann-Hwa Chen, Wei-Lung
Description	Country affiliation: Taiwan Author Affiliation: Huang CC ( Department of Emergency Medicine, Cathay General Hospital, and School of Medicine, Fu-Jen Catholic University, Taipei 242, Taiwan.)
Abstract	OBJECTIVE: The aim of this study was to investigate if the electrocardiographic (ECG) abnormalities assessed early in the emergency department (ED) are associated with the in-hospital mortality of the patients with spontaneous subarachnoid hemorrhage (SAH). METHODS: We studied prospectively a cohort of 222 adult patients with spontaneous SAH in an ED. A 12-lead ECG was performed for these patients in the ED. The patients were stratified into nonsurvivors and survivors based on the in-hospital mortality. The clinical characteristics, heart rate, corrected QT interval (QTc) and 7 predefined morphologic abnormalities were compared between these 2 groups of patients. RESULTS: Compared with the survivors (n=178), the nonsurvivors (n=44) had significantly slower heart rate (75±23 vs 83±16, P=.018) and more prolonged QTc (492±58 vs 458±40, P=.001). There were significantly higher frequency of occurrence of ECG morphologic abnormalities (66% vs 37%, P=.001) and nonspecific ST- or T-wave changes (NSSTTCs; 32% vs 12%, P=.015) in the nonsurvivors compared with those in the survivors. Multiple logistic regression model identified QTc (odds ratio, 1.0; 95% confidence interval, 1.0-1.0; P=.005) and NSSTTC (odds ratio, 3.3; 95% confidence interval, 1.0-10.7; P=.047) as the significant ECG variables associated with in-hospital mortality. CONCLUSIONS: The occurrence of NSSTTC and prolonged QTc assessed early in the ED are independently associated with the in-hospital mortality in adult patients with spontaneous SAH.
File Format	HTM / HTML
ISSN	07356757
Issue Number	5
Volume Number	30
e-ISSN	15328171
Journal	The American Journal of Emergency Medicine
Language	English
Publisher	Elsevier
Publisher Date	2012-06-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency Discipline Medicine Electrocardiography Methods Heart Rate Physiology Subarachnoid Hemorrhage Diagnosis Chi-square Distribution Emergency Service, Hospital Female Hospital Mortality Humans Logistic Models Male Middle Aged Odds Ratio Predictive Value Of Tests Prognosis Prospective Studies Mortality Physiopathology Journal Article
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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