@article{c2d020bfc83e4b1aacc8d260afd4f679,
title = "QTc prolongation as a marker of 30-day serious outcomes in older patients with syncope presenting to the Emergency Department",
abstract = "Background: Syncope is a common chief complaint in the ED, and the electrocardiogram (ECG) is a routine diagnostic tool in the evaluation of syncope. We assessed whether increasingly prolonged QTc intervals are associated with composite 30-day serious outcomes in older adults presenting to the ED with syncope. Methods: This is a secondary analysis of a prospective, observational study at 11 EDs in adults 60 years or older who presented with syncope or near syncope. We excluded patients presenting without an ECG, measurement of QTc, non-sinus rhythm, bundle branch block or those without 30-day follow-up. We categorized QTc cutoffs into values of <451; 451–470; 471–500, and >500 ms. We determined the rate of composite 30-day serious outcomes including ED serious outcomes and 30-day arrhythmias not identified in ED. Results: The study cohort included 2609 patients. There were 1678 patients (64.3%) that had QTc intervals <451 ms; 544 (20.8%) were 451–470 ms; 302 (11.6%) were 471–500 ms, and 85 (3.3%) had intervals >500 ms. Composite 30-day serious outcomes was associated with increasingly prolonged QTc intervals (13.0%, 15.3%, 18.2%, 22.4%, p = 0.01), but this association did not persist in multivariate analysis. Conclusions: In a cohort of older patients presenting with syncope, increased QTc interval was a marker of but was not independently predictive of composite 30-day serious outcomes.",
author = "White, {Jennifer L.} and Chang, {Anna Marie} and Hollander, {Judd E.} and Erica Su and Weiss, {Robert E.} and Yagapen, {Annick N.} and Malveau, {Susan E.} and Adler, {David H.} and Aveh Bastani and Baugh, {Christopher W.} and Caterino, {Jeffrey M.} and Clark, {Carol L.} and Diercks, {Deborah B.} and Nicks, {Bret A.} and Nishijima, {Daniel K.} and Shah, {Manish N.} and Stiffler, {Kirk A.} and Storrow, {Alan B.} and Wilber, {Scott T.} and Sun, {Benjamin C.}",
note = "Funding Information: AMC has received research funding from Abbott, Akers, Alere, Nanomix, Siemens, Roche, Ortho Diagnostics, Portola and Trinity. Funding Information: CWB has received advisory board and speaker's fees from Roche, research funding from Janssen and Boehringer Ingelheim and consulting and advisory board fees from Janssen. Funding Information: CLC has received research funding from Astra Zeneca, Radiometer, Ortho clinical trials, Janssen, Pfizer, NIH, Portola, Biocryst, Glaxo Smith Klein, Hospital Quality Foundation, and Abbott. She is a consultant for Portola, Janssen, and Hospital Quality Foundation. Funding Information: Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number R01HL111033 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: JEH has received research funding from Alere, Siemens, Roche, Portola and Trinity. Funding Information: AB has received research funding from Radiometer and Portola and has been a consultant for Portola. Publisher Copyright: {\textcopyright} 2018 Elsevier Inc.",
year = "2019",
month = apr,
doi = "10.1016/j.ajem.2018.07.022",
language = "English (US)",
volume = "37",
pages = "685--689",
journal = "American Journal of Emergency Medicine",
issn = "0735-6757",
publisher = "W.B. Saunders Ltd",
number = "4",
}