The following is a summary of “QTc prolongation after aneurysmal subarachnoid hemorrhage might be associated with worse neurologic outcome in patients receiving microsurgical clipping or embolization of the intracranial aneurysms: a retrospective observational study,” published in the May 2024 issue of Neurology by Zhnag et al.
Researchers conducted a retrospective study to investigate whether prolonged QT interval (QTc) on electrocardiographic (ECG) is associated with cardiac complications or poor long-term neurological outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH).
They involved adult (≥18 years) patients (between Jan 2018 and Dec 2020) for aSAH who underwent intracranial aneurysm clipping or embolization. Patients were categorized into two groups (standard and QTc prolongation) based on the QTc intervals. To address confounding bias, propensity score matching (PSM) analysis was performed to compare neurological outcomes between patients with normal QTc and QTc prolongation.
The results showed 908 screened patients; 714 belonged to the normal QTc group and 194 to the long QTc group. Factors associated with QTc prolongation included female sex, hypokalemia, posterior circulation aneurysm, and higher Hunt-Hess grade. In multiple regression analysis, older age, higher hemoglobin level, posterior circulation aneurysm, and higher Hunt-Hess grade were linked to worse outcomes during 1-year follow-up. Before PSM, patients with QTc prolongation had a higher rate of perioperative cardiac arrest or ventricular arrhythmias. In post-PSM, no statistical difference in perioperative cardiac events between normal and QTc prolongation groups. However, patients in the QTc prolongation group still experienced worse neurological outcomes during 1-year follow-up.
Investigators found that a prolonged QTc interval in patients with aSAH predicted poorer outcomes independent of heart complications during treatment.
Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03679-z
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