摘要
AIM To determine the prevalence of QT prolongation in a large series of end stage liver disease(ESLD) patients and its association to clinical variables and mortality.METHODS The QT interval was measured and corrected for heart rate for each patient,with a prolonged QT cutoff defined as QT > 450 ms for males and QT > 470 ms for females.Multiple clinical variables were evaluated including sex,age,serum sodium,international normalized ratio,creatinine,total bilirubin,beta-blocker use,Model for EndStage Liver Disease(MELD),MELD-Na,and etiology of liver disease. RESULTS Among 406 ESLD patients analyzed,207(51.0%) had QT prolongation. The only clinical variable associated with QT prolongation was male gender(OR = 3.04,95%CI:2.01-4.60,P < 0.001). During the study period,187patients(46.1%) died. QT prolongation was a significant independent predictor of mortality(OR = 1.69,95%CI:1.03-2.77,P = 0.039). In addition,mortality was also associated with viral etiology of ESLD,elevated MELD score and its components(P < 0.05 for all). No significant reversibility in the QT interval was seen after liver transplantation. CONCLUSION QT prolongation was commonly encountered in an ESLD population,especially in males,and served as a strong independent marker for increased mortality in ESLD patients.
AIM To determine the prevalence of QT prolongation in a large series of end stage liver disease(ESLD) patients and its association to clinical variables and mortality.METHODS The QT interval was measured and corrected for heart rate for each patient,with a prolonged QT cutoff defined as QT > 450 ms for males and QT > 470 ms for females.Multiple clinical variables were evaluated including sex,age,serum sodium,international normalized ratio,creatinine,total bilirubin,beta-blocker use,Model for EndStage Liver Disease(MELD),MELD-Na,and etiology of liver disease. RESULTS Among 406 ESLD patients analyzed,207(51.0%) had QT prolongation. The only clinical variable associated with QT prolongation was male gender(OR = 3.04,95%CI:2.01-4.60,P < 0.001). During the study period,187patients(46.1%) died. QT prolongation was a significant independent predictor of mortality(OR = 1.69,95%CI:1.03-2.77,P = 0.039). In addition,mortality was also associated with viral etiology of ESLD,elevated MELD score and its components(P < 0.05 for all). No significant reversibility in the QT interval was seen after liver transplantation. CONCLUSION QT prolongation was commonly encountered in an ESLD population,especially in males,and served as a strong independent marker for increased mortality in ESLD patients.
