Is the widening of the QTc associated with mortality in sepsis?

Introduction

The widening of the QTc is a mortality predictor in acute coronary syndromes and cerebral vascular accident.

Objective

To study the alterations on the correlation among QTc, troponin and the echocardiogram with sepsis mortality.

Methods

Holter and echocardiogram were performed, where we were able to analyze the QTc space and the chamber's size. We checked the troponin, CPK and CKMB levels on the 1st, 6th and 12th day after admission. Magnesium and potassium levels were also checked.

Results

Nineteen patients were studied. Ten of them died (52%). The APACHE score (29.8 ± 8.4 and 26.8 ± 6.5) and age (48 ± 6.4 and 58 ± 6.4 years) were similar in survivor and nonsurvivor groups, respectively. There was no meaningful difference in the daily dosage of vocative drips. Troponin was significantly elevated among those who died during the first 12 days (day 1: 0.5 ± 0.3 and 1.4 ± 1.1; day 6: 0.4 ± 0.1 and 1.4 ± 1.2; day 12: 0.3 ± 0.1 and 1.0 ± 0.8; P < 0.05). The QTc was elevated in the nonsurvivor group (day 1: 0.44 ± 0.05 and 0.46 ± 0.04; day 6: 0.45 ± 0.05 and 0.46 ± 0.08; day 12: 0.41 ± 0.02 and 0.45 ± 0.09; P < 0.05 – survivors and nonsurvivors, respectively). There was an increase in acute events in the nonsurvivor group (40 ± 6 mm) on the 12-day trial.

Conclusion

QTc, troponin and acute event data were elevated among the nonsurvivor patients. There is therefore an evident correlation of these parameters and their clinical evolution.