Clinical significance of prolonged QTc dispersion in spontaneous intracranial hemorrhage

Introduction

QTc dispersion is a new important prognostic factor for many disease. We have analyzed the admission EKGs of 53 patients with spontaneous intracranial hemorrhage (ICH) for their QTc dispersion. This study is performed to investigate the prognostic characteristics of QTc dispersion in patients with ICH.

Methods

On presentation, we measured the QTc dispersion of the ECG and Glasgow Coma Scale (GCS) of patients. The QTc dispersion is the difference in the QT duration of the longest minus the shortest rate-corrected QT interval. Computer tomography of the brain was performed in order to determine the site of the ICH, the presence of intraventricular hemorrhage (IVH) and the amount of ICH. We attempted to determine the relationship between initial factors, including QTc dispersion and findings of computer tomography, as well as the Glasgow Outcome Scale (GOS) at discharge as the final prognosis.

Results

Patients exhibited a poor prognosis if they had a lower GCS score on admission, larger volume of hemorrhage and accompanying IVH at computer tomography scan of brain, and increased QTc dispersion on univariate analyses. Although the mean QTc dispersion in the group that showed a favorable outcome was 70.6 ± 29.6 ms, and 63.8 ± 24.2 ms in the group of GOS 1 and 76.8 ± 26.4 ms in the group of GOS 2, the mean QTc dispersion in the group that had an unfavorable outcome was 117.6 ± 36.1 ms; 108.8 ± 29.6 ms in the group of GOS 3, 120.7 ± 1.3 ms in the group of GOS 4 and 141.8 ± 53.4 ms in the group of GOS 5. The difference in the QTc dispersion according to patient outcome was statistically significant.

Conclusion

The QTc dispersion in the initial EKG might be a significant factor that could be useful for prediction of outcome in spontaneous ICH patients along with the GOS at discharge. Our results therefore suggest that the QTc dispersion should be included for prognosis and treatment of patients with ICH.