title: Corrected QT interval anomalies are associated with worse prognosis among patients suffering from sepsis.
abstract: BACKGROUND
  Patients suffering from sepsis experience organ failure and metabolic derangements, with a negative impact on their prognosis and survival. Objective markers for dismal prognosis in this group of patients are sought.
  
  
  OBJECTIVE
  To assess the potential role of corrected QT interval anomalies as surrogates for metabolic derangements leading to increased short and medium-term mortality in patients suffering from sepsis.
  
  
  METHODS
  This study utilised a historic-cohort analysis of 257 septic patients admitted to internal medicine departments. Personal data, vital signs, laboratory results and electrocardiograms were collected. Patients were grouped according to QTc duration, weather mid-range (395-490 ms) or non-mid-range, and further defined as shorter (<395 ms) or longer (>490 ms).
  
  
  RESULTS
  Mortality rates differed significantly between the mid-range QTc group and the non-mid-range groups at 14 days (23.7 vs 38.2%, respectively; P = 0.014) and at 3 months (38.5 vs 59.6%, respectively; P = 0.001). In a three-group analysis, the 14-day mortality was the highest in the longer QTc group and the lowest in the mid-range group compared with the shorter QTc group (44.4, 23.7 and 35.5%, respectively; P = 0.034), and this difference also remained at 3 months (74.1, 38.5 and 53.2%, respectively; P = 0.001). All differences remained statistically significant in a multivariate Cox regression analysis.
  
  
  CONCLUSIONS
  QTc duration anomalies are associated with worse short- and medium-term prognosis and may act as a marker for more severe clinical sequelae.
authors.affiliation: Sackler School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Wasserstrum
authors.affiliation: Internal Medicine 'T', Chaim Sheba Medical Center, Tel Ha'Shomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Lotan
authors.affiliation: Sackler School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Itelman
authors.affiliation: Internal Medicine 'T', Chaim Sheba Medical Center, Tel Ha'Shomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Barbarova
authors.affiliation: Internal Medicine 'T', Chaim Sheba Medical Center, Tel Ha'Shomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Kogan
authors.affiliation: Leviev Heart Institute, Chaim Sheba Medical Center, Tel Ha'Shomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Klempfner
authors.affiliation: Internal Medicine 'T', Chaim Sheba Medical Center, Tel Ha'Shomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Dagan
authors.affiliation: Internal Medicine 'T', Chaim Sheba Medical Center, Tel Ha'Shomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. gad.segal@sheba.health.gov.il.
authors.forename: G
authors.initials: G
authors.lastname: Segal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D007557:Israel; D053208:Kaplan-Meier Estimate; D008133:Long QT Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications* / Q000401:mortality*
keywords: QT interval; corrected QT; internal medicine; mortality; prognosis; sepsis