QRS voltage is a predictor of in-hospital mortality of acutely ill medical patients.
Clin Cardiol. 2018 Jul 18;:
Authors: Kellett J, Opio MO, Kitovu Hospital Study Group
BACKGROUND: low QRS voltage has been shown to be associated with increased mortality in the general population and in a small pilot study the combined QRS voltage of ECG leads I and II was found to be associated with in-hospital mortality AIM: confirm that low QRS voltage predicts the in-hospital mortality of acutely ill patients, and compare QRS voltage with other predictors of mortality that can be easily, quickly and cheaply obtained at the bedside METHODS: prospective observational study of vital signs, QRS voltage and simple tools used to assess mental, functional and nutritional status at the bedside in unselected acutely ill patients admitted to a resource-poor hospital in sub-Saharan Africa.
RESULTS: out of 1,486 patients 77 died (5.2%) died in hospital. A combined lead I + II voltage <1.8 mV was present in 789 (53.1%) of patients, and significantly associated with in-hospital mortality (odds ratio 3.6, 95% CI 2.0 - 6.5, Chi square 21.2, p <0.00001). On logistic regression impaired mobility, the National Early Warning Score, male gender and lead I+II voltage were the only independent predictors of mortality. None of the 445 patients who were mobile on admission with a lead I+II voltage ≥1.8 mV died in hospital.
CONCLUSION: low QRS voltage, male gender, NEWS and impaired mobility were independent predictors of in-hospital mortality in the study population. These four variables, which are easily obtained at the bedside, could potentially provide a rapid, easy and cheap risk stratification system.
PMID: 30022511 [PubMed - as supplied by publisher]