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. 2026 Jan 16;26(1):67.
doi: 10.1186/s12872-026-05519-z.

QT interval prolongation and mortality in sepsis: a retrospective cohort study from the MIMIC-IV database

Jin-You Zhang  1 , Yang Chen  1 , Ying-Xi Zhang  2 , Bao-Jun Yang  3
Affiliations

QT interval prolongation and mortality in sepsis: a retrospective cohort study from the MIMIC-IV database

Jin-You Zhang et al. BMC Cardiovasc Disord. .

Abstract

Background: Sepsis is a leading cause of mortality in patients admitted to the intensive care unit (ICU), and QT prolongation (QTP) is common in critically ill patients. However, the association between QTP and long-term mortality in sepsis remains unexamined.

Methods: This retrospective study included patients meeting the Sepsis-3 criteria upon ICU admission between 2008 and 2019, identified from the Intensive Care Medical Information Mart IV (MIMIC-IV) database. Patients were categorized into two groups based on the presence (QTP group) or absence (non-QTP group) of QTP. Clinical outcomes were compared between patients with and without QTP. We used Kaplan–Meier analysis to compare the 28-day and 1-year all-cause mortality between septic patients with and without QTP. Furthermore, we utilized multivariate regression, propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and a survey-weighted generalized linear model to assess the association of QTP with 28-day and 1-year all-cause mortality in patients with sepsis.

Results: A total of 4,845 patients were enrolled, with 1,424 (29.4%) in the QTP group. Compared with the non-QTP patients, the QTP group had significantly higher 28-day mortality (19.17% vs. 13.15%, p < 0.001) and 1-year mortality (33.99% vs. 24.82%, p < 0.001). Following PSM, the QTP group exhibited significantly higher mortality at both 28-day mortality (18.81% vs. 15.51%, p < 0.05) and 1-year mortality (33.60% vs. 27.64%, p < 0.001) compared to the non-QTP group. Patients in the QTP group exhibited increased risk of both 28-day mortality (adjusted OR = 1.34, 95% CI: 1.11–1.61, p = 0.002) and 1-year mortality (adjusted OR = 1.40, 95% CI: 1.20–1.63, p < 0.001).

Conclusion: The incidence of QTP was significantly elevated in ICU patients with sepsis compared with the general population and QTP was associated with increased risk-adjusted 28-day and 1-year mortality in ICU patients with sepsis.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12872-026-05519-z.

Keywords: Mortality; Multivariable analysis; Propensity score matching; QT prolongation; Sepsis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The MIMIC database was approved by the Institutional Review Boards (IRBs) of the Massachusetts Institute of Technology and Beth Israel Deaconess Medical Center. This study adhered to the ethical principles of the Declaration of Helsinki and was approved by both institutions. As patient data was de-identified, individual informed consent was not required. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram in the present study
Fig. 2
Fig. 2
Change in standardized mean difference (SMD) before and after matching of cohort
Fig. 3
Fig. 3
28-day Kaplan–Meier survival curves
Fig. 4
Fig. 4
1-year Kaplan–Meier survival curves
See this image and copyright information in PMC

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