title: Association between a prolonged corrected QT interval and outcomes in patients in a medical Intensive Care Unit.
abstract: BACKGROUND
  Patients admitted into a medical Intensive Care Unit (ICU) have varying illnesses and risk factors. An electrocardiogram (ECG) is a useful tool to assess the cardiac status. The aim of the study was to determine the prevalence of QT prolongation of the ECG in patients admitted to a medical ICU in a tertiary hospital, to assess outcomes in terms of mortality, cardiovascular events, and duration of ICU stay.
  
  
  METHODS
  Prospective observational study, 6 months duration, assessing the prevalence of prolonged corrected QT interval (QTc) at admission into a medical ICU. A QTc calculated by Bazett's formula, of >440 ms for males and >460 ms for females was considered prolonged. Details of illness, clinical and lab parameters were monitored.
  
  
  RESULTS
  The total number of patients screened was 182. There was a high prevalence of prolonged QTc (30%) on admission to the ICU. This reduced to 19% on day 3 (P = 0.011). In patients with a prolonged QTc the odds ratio of adverse outcome from ICU was 3.17 (confidence interval [CI]: 1.52-6.63) (P = 0.001) and of adverse outcome for hospital stay was 2.27 (CI: 1.11-4.66) (P = 0.014). In the study, 35% of all patients received drugs with QT prolonging action. Of patients with a prolonged QTc at admission 18 (35%) received a QT prolonging drug.
  
  
  CONCLUSIONS
  We found that prolonged QTc is common (30%) in our medical ICU at admission and a large proportion (35%) received drugs capable of prolonging QT interval. These patients with QTc prolongation have a higher odds ratio for adverse outcomes.
authors.affiliation: Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Tarun K
authors.initials: TK
authors.lastname: George
authors.affiliation: Department of Cardiology Electrophysiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: David
authors.initials: D
authors.lastname: Chase
authors.affiliation: Department of Critical Care Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: John Victor
authors.initials: JV
authors.lastname: Peter
authors.affiliation: Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Sowmya
authors.initials: S
authors.lastname: Satyendra
authors.affiliation: Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: R
authors.initials: R
authors.lastname: Kavitha
authors.affiliation: Department of Anaesthesiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Leah Raju
authors.initials: LR
authors.lastname: George
authors.affiliation: Department of Critical Care Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Vineeth Varghese
authors.initials: VV
authors.lastname: Thomas
keywords: Critical care; India; QT prolongation; electrocardiography; intensive care unit; predictors