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. 2019 Aug 1;21(8):1254-1260.
doi: 10.1093/europace/euz058.

QT prolongation predicts short-term mortality independent of comorbidity

Charlotte Gibbs  1   2 , Jacob Thalamus  1 , Doris Tove Kristoffersen  3 , Martin Veel Svendsen  4 , Øystein L Holla  5 , Kristian Heldal  1   2 , Kristina H Haugaa  2   6 , Jan Hysing  1
Affiliations

QT prolongation predicts short-term mortality independent of comorbidity

Charlotte Gibbs et al. Europace. .

Abstract

Aims: A prolonged corrected QT interval (QTc) ≥500 ms is associated with high all-cause mortality in hospitalized patients. We aimed to explore any difference in short- and long-term mortality in patients with QTc ≥500 ms compared with patients with QTc <500 ms after adjustment for comorbidity and main diagnosis.

Methods and results: Patients with QTc ≥500 ms who were hospitalized at Telemark Hospital Trust, Norway between January 2007 and April 2014 were identified. Thirty-day and 3-year all-cause mortality in 980 patients with QTc ≥500 ms were compared with 980 patients with QTc <500 ms, matched for age and sex and adjusting for Charlson comorbidity index (CCI), previous admissions, and main diagnoses. QTc ≥500 ms was associated with increased 30-day all-cause mortality [hazard ratio (HR) 1.90, 95% confidence interval (CI) 1.38-2.62; P < 0.001]. There was no significant difference in mortality between patients with QTc ≥500 ms and patients with QTc <500 ms who died between 30 days and 3 years; 32% vs. 29%, P = 0.20. Graded CCI was associated with increased 3-year all-cause mortality (CCI 1-2: HR 1.62, 95% CI 1.34-1.96; P < 0.001; CCI 3-4: HR 2.50, 95% CI 1.95-3.21; P < 0.001; CCI ≥5: HR 3.76, 95% CI 2.85-4.96; P < 0.001) but was not associated with 30-day all-cause mortality.

Conclusion: QTc ≥500 ms is a powerful predictor of short-term mortality overruling comorbidities. QTc ≥500 ms also predicted long-term mortality, but this effect was mainly caused by the increased short-term mortality. For long-term mortality, comorbidity was more important.

Keywords: All-cause mortality; Arrhythmia; Charlson comorbidity index; Long QT syndrome; Risk factor.

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Figures

Figure 1
Figure 1
Flow chart showing patients with a QTc ≥500 ms and patients with a QTc <500 ms identified at each stage of the selection process.
Figure 2
Figure 2
Thirty-day (A) and 3-year (B) survival curves of 980 patients with QTc ≥500 ms compared with 980 patients with QTc <500 ms.
See this image and copyright information in PMC

References

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