title: ECG dispersion mapping predicts clinical deterioration, measured by increase in the Simple Clinical Score.
abstract: OBJECTIVE
  ECG dispersion mapping (ECG-DM) is a novel technique that reports abnormal ECG microalternations. We report the ability of ECG-DM to predict clinical deterioration of acutely ill medical patients, as measured by an increase in the Simple Clinical Score (SCS) the day after admission to hospital.
  
  
  METHODS
  453 acutely ill medical patients (mean age 69.7 +/- 14.0 years) had the SCS recorded and ECGDM performed immediately after admission to hospital.
  
  
  RESULTS
  46 patients had an SCS increase 20.8 +/- 7.6 hours after admission. Abnormal micro-alternations during left ventricular re-polarization had the highest association with SCS increase (p=0.0005). Logistic regression showed that only nursing home residence and abnormal micro-alternations during re-polarization of the left ventricle were independent predictors of SCS increase with an odds ratio of 2.84 and 3.01, respectively.
  
  
  CONCLUSIONS
  ECG-DM changes during left ventricular re-polarization are independent predictors of clinical deterioration the day after hospital admission.
authors.affiliation: Department of Medicine, Nenagh Hospital, Nenagh, County Tipperary, Ireland. jgkellett@eircom.net
authors.forename: J
authors.initials: J
authors.lastname: Kellett
authors.forename: A
authors.initials: A
authors.lastname: Emmanuel
authors.forename: S
authors.initials: S
authors.lastname: Rasool
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018780:Body Surface Potential Mapping / Q000379:methods*; D015331:Cohort Studies; D018450:Disease Progression; D004562:Electrocardiography / Q000379:methods; D004636:Emergency Service, Hospital; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000401:mortality*