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. 2025 Jul 10;14(14):4911.
doi: 10.3390/jcm14144911.

Association Between ST-Segment Deviation in Electrocardiography and 30-Day Mortality in Non-Cardiac Critically Ill Patients: A Retrospective Single-Center Study

Rafał Świstek  1 , Emil Dadański  2 , Aleksandra Kurzyca  2 , Jakub Droś  1 , Patryk Kasongo  1 , Jakub Konieczyński  1 , Joanna Jóźwik  3 , Tomasz Drygalski  1 , Michał Terlecki  1
Affiliations

Association Between ST-Segment Deviation in Electrocardiography and 30-Day Mortality in Non-Cardiac Critically Ill Patients: A Retrospective Single-Center Study

Rafał Świstek et al. J Clin Med. .

Abstract

Background/Objectives: ST-segment deviation (STD) on electrocardiography (ECG) may reflect myocardial injury in critically ill patients. However, its prognostic significance in non-cardiac intensive care unit (ICU) populations remains unclear. We aimed to assess the association between STD on ICU admission and 30-day mortality and to evaluate its incremental prognostic value beyond the SOFA score. Methods: In this retrospective single-center study, we included 307 consecutive ICU patients (median age: 64.0 years; 65.5% men). Patients with acute cardiac conditions were excluded. STD was defined as ≥1 mm ST elevation or depression in any lead on standard 12-lead ECG performed on admission. The primary outcome was 30-day all-cause mortality. Prognostic associations were assessed using multivariable Cox regression adjusted for SOFA score. Discriminative performance was evaluated by comparing ROC curves for models with and without STD, with bootstrap-based testing (1000 iterations) to assess significance. Results: STD was present in 126 patients (41.0%) and occurred more frequently in non-survivors (47.6% vs. 36.5%, p = 0.033. In Cox regression, STD was independently associated with 30-day mortality (HR = 1.534; 95% CI: 1.081-2.177; p = 0.017), even after adjustment for SOFA score. This association remained statistically robust in bootstrap validation. The addition of STD amplitude to the SOFA score modestly improved model discrimination with a borderline significant difference between the areas under the curve (ΔAUC = 0.005, p = 0.0581). Conclusions: ST-segment deviation on the admission ECG is an independent predictor of 30-day mortality in non-cardiac critically ill patients and may enhance risk stratification beyond the SOFA score.

Keywords: ECG; QRS prolongation; QT interval; SOFA score; ST deviation; critical care.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the study. Abbreviations: ICU—intensive care unit, ECG—electrocardiogram.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curves comparing the performance of the SOFA score alone and the SOFA score combined with the amplitude of ST-segment deviation on admission ECG in predicting 30-day mortality.
See this image and copyright information in PMC

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References

    1. Moreno R., Rhodes A., Piquilloud L., Hernandez G., Takala J., Gershengorn H.B., Tavares M., Coopersmith C.M., Myatra S.N., Singer M., et al. The Sequential Organ Failure Assessment (SOFA) Score: Has the time come for an update? Crit. Care. 2023;27:15. doi: 10.1186/s13054-022-04290-9. - DOI - PMC - PubMed
    1. Arts D.G., de Keizer N.F., Vroom M.B., de Jonge E. Reliability and accuracy of Sequential Organ Failure Assessment (SOFA) scoring. Crit. Care Med. 2005;33:1988–1993. doi: 10.1097/01.CCM.0000178178.02574.AB. - DOI - PubMed
    1. Vincent J.L., Moreno R., Takala J., Willatte S., Mendonça A.D., Bruining H., Reinhart C.K., Suter P.M., Thijs L.G. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22:707–710. doi: 10.1007/BF01709751. - DOI - PubMed
    1. Russell J.A. Vasopressor therapy in critically ill patients with shock. Intensive Care Med. 2019;45:1503–1517. doi: 10.1007/s00134-019-05801-z. - DOI - PubMed
    1. Kouz K., Thiele R.H., Michard F., Saugel B. Haemodynamic monitoring during noncardiac surgery: Past, present, and future. J. Clin. Monit. Comput. 2024;38:565–580. doi: 10.1007/s10877-024-01161-2. - DOI - PMC - PubMed

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