Prognostic Value of QT Parameters in Patients with Acute Hemorrhagic Stroke: A Prospective Evaluation with Respect to Mortality and Post-hospitalization Bed Confinement

Abstract

Background: 

This prospective study was performed to evaluate the prognostic prediction value of QT parameters and clinical characteristics exhibited by patients with acute hemorrhagic stroke at the time of presenting to the emergency department (ED).

Methods: 

One hundred and sixty-six patients admitted to the ED of Taipei Veterans General Hospital from January 2006 to October 2006 because of acute hemorrhagic stroke were enrolled. Glasgow Coma Scale (GCS) scores between 3 and 8 were taken to indicate severe neurologic deficits. QT parameters (QT max, QT min, QT dispersion, QTc max, QTc min, QTc dispersion) and other pertinent clinical variables were determined on admission. Logistic regression model was applied to evaluate prognostic prediction values.

Results: 

Mortality was higher among stroke patients with low GCS scores (p < 0.01). Leukocyte counts and systolic blood pressures were significantly higher among non-surviving patients (p = 0.04). No association was found between QT parameters and mortality (all p > 0.05). Among survivors, post-hospitalization bed confinement was required for those significantly older (p = 0.01) and those with higher QT max and QTc max values in multivariate analyses (p = 0.04 and p < 0.01, respectively).

Conclusion: 

Low GCS scores, increased leukocyte counts, and elevated systolic blood pressures predict increased mortality for subjects with acute hemorrhagic stroke. Advanced age and prolongations in QTc and QT max at the time of stroke predicted poor functional recovery for these subjects.