Multivariate analysis of risk factors for QT prolongation following subarachnoid hemorrhage.
BACKGROUND
Subarachnoid hemorrhage (SAH) often causes a prolongation of the corrected QT (QTc) interval during the acute phase. The aim of the present study was to examine independent risk factors for QTc prolongation in patients with SAH by means of multivariate analysis.


METHODS
We studied 100 patients who were admitted within 24 hours after onset of SAH. Standard 12-lead electrocardiography (ECG) was performed immediately after admission. QT intervals were measured from the ECG and were corrected for heart rate using the Bazett formula. We measured serum levels of sodium, potassium, calcium, adrenaline (epinephrine), noradrenaline (norepinephrine), dopamine, antidiuretic hormone, and glucose.


RESULTS
The average QTc interval was 466 +/- 46 ms. Patients were categorized into two groups based on the QTc interval, with a cutoff line of 470 ms. Univariate analyses showed significant relations between categories of QTc interval, and sex and serum concentrations of potassium, calcium, or glucose. Multivariate analyses showed that female sex and hypokalemia were independent risk factors for severe QTc prolongation. Hypokalemia (<3.5 mmol/l) was associated with a relative risk of 4.53 for severe QTc prolongation as compared with normokalemia, while the relative risk associated with female sex was 4.45 as compared with male sex. There was a significant inverse correlation between serum potassium levels and QTc intervals among female patients.


CONCLUSIONS
These findings suggest that female sex and hypokalemia are independent risk factors for severe QTc prolongation in patients with SAH.
Fukui
Shinji
S
Department of Neurosurgery, National Defense Medical College, Tokorozawa, Japan. ndmcsf@aol.com
Katoh
Hiroshi
H
Tsuzuki
Nobusuke
N
Ishihara
Shoichiro
S
Otani
Naoki
N
Ooigawa
Hidetoshi
H
Toyooka
Terushige
T
Ohnuki
Akira
A
Miyazawa
Takahito
T
Nawashiro
Hiroshi
H
Shima
Katsuji
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000097:blood / Q000150:complications; D008133:Long QT Syndrome / Q000097:blood / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013345:Subarachnoid Hemorrhage / Q000150:complications*
D001786:Blood Glucose; D011188:Potassium; D002118:Calcium