Frontal QRS-T Angle in Predicting Short-Term Mortality in Patients with SARS-CoV 2 Infection in Emergency Service: An Analytical Study
Abstract
Aim: Current study sought to examine relationship of frontal QRS-T angle with mortality and its ability
to predict mortality.
Material and Methods: This retrospective study was made in an education hospital with SARS-CoV 2
infected patients admitted to emergency service between 01/01/2021 and 07/01/2021. Patients were
grouped as survivor and died according to 30-day all-cause mortality data. Groups were matched in
footings of comorbidities, demographics, laboratory parameters and ECG findings. Receiver operating
characteristic examination was used for evaluation of the ability of frontal QRS-T angle to predict shortterm
mortality.
Results: The frontal QRS-T angle was greater in died group compared to the survivors (53 (25.5-
115.5) vs 28 (13-52) p<0.001). According to the receiver operating characteristic analysis, the cut-off
and area under the curve were determined as 41.5 (sensitivity: 62.2%, specificity: 64.7%) and 0.659
(95% confidence interval: 0.606-0.713), respectively for frontal QRS-T angle for 30-day mortality. The
odds ratio of frontal QRS-T angle (≥41.5) was determined as 3.03 (95% confidence interval: 2.08-4.42).
Conclusion: Frontal QRS-T angle is a predictor with high specificity for short-term mortality in the
emergency department in with patients SARS-CoV 2 infection.
References
- 1. Mahinrad S, Ferguson I, Macfarlane PW, Clark EN, Stott DJ, Ford I, Mooijaart SP, Trompet S, van Heemst D, Jukema JW, Sabayan B. Spatial QRS-T Angle and Cognitive Decline in Older Subjects. J Alzheimers Dis. 2019;67(1):279-289.
- 2. Dogan A, Kahraman S. Frontal QRS-T angle predicts coronary atherosclerotic burden in patients with ST segment elevation myocardial infarction. J Electrocardiol. 2020;58:155-159.
- 3. Hayiroglu Mİ, Asarcikli LD, Osken A, Keskin K, Kolak Z, Unal S. Frontal QRS-T angle may predict reverse dipping pattern in masked hypertensives. Clin Exp Hypertens. 2022;44(4):2043892.
- 4. Oehler A, Feldman T, Henrikson CA, Tereshchenko LG. QRS-T angle: a review. Ann Noninvasive Electrocardiol 2014;19(6):534-542.
- 5. Zadeh B, Wambach JM, Lambers M, Nassenstein K, Jensen CJ, Bruder O. QRS-T-angle in Patients with ST-Segment Elevation Myocardial Infarction (STEMI) - a Comparison with Cardiac Magnetic Resonance Imaging. Int J Med Sci 2020;17(15):2264-2268.
- 6. Özkan A. Evaluation of short-term mortality prediction using initial lactate and NEWS+L at admission in COVID-19 patients. Disaster Med Public Health Prep 2023;17:e333.
- 7. Özdemir S, Algın A, Akça HŞ, Altunok İ, Kokulu K, Eroğlu SE, Aksel G. Predictive ability of the MEWS, REMS, and RAPS in geriatric patients with SARS-CoV-2 infection in the emergency department. Disaster Med Public Health Prep 2022;17:e174.
- 8. Özkan A. Diagnostic accuracy of clinical gestalt of doctors with different experiences in COVID-19 suspected patients. J Exp Clin Med 2022;39(3):738-742.
- 9. Aslaner Ak M, Sahip B, Çelebi G, Horuz E, Ertop Ş. Abnormalities of peripheral blood parameters in hospitalized patients with COVID-19: a temporal change analysis in relation to survival. Med J West Black Sea 2021;5(3):391-400.
- 10. Akça HŞ, Algın A, Özdemir S, Sevimli H, Kokulu K, Eroğlu SE. Comparison of the efficacy of PSI, CURB-65, CALL and BCRSS in predicting prognosis and mortality in COVID-19 patients. J Exp Clin Med 2021;38(4):434-443.
- 11. Yılmam İ, Gegin S. Evaluation of patient characteristics and pandemic management in the first three months of the COVID-19 Pandemic at the. Med J West Black Sea 2021;5(3):386-390.
- 12. Algın A, Özdemir S. Evaluation of the predictability of platelet mass index for short-term mortality in patients with COVID 19: a retrospective cohort study. J Contemp Med 2021;11(5):728- 733.
- 13. Bergamaschi L, D’Angelo EC, Paolisso P, Toniolo S, Fabrizio M, Angeli F, Donati F, Magnani I, Rinaldi A, Bartoli L, Chiti C, Biffi M, Pizzi C, Viale P, Galié N. The value of ECG changes in risk stratification of COVID-19 patients. Ann Noninvasive Electrocardiol 2021;26(3):e12815.
- 14. Chorin E, Dai M, Kogan E, Wadhwani L, Shulman E, Nadeau- Routhier C, Knotts R, Bar-Cohen R, Barbhaiya C, Aizer A, Holmes D, Bernstein S, Spinelli M, Park D, Chinitz L, Jankelson L. Electrocardiographic risk stratification in COVID-19 patients. Front Cardiovasc Med 2021;8:63607
- 15. Jabbari L, Hayati S, Azizkhani L, Tavakol J. Association of electrocardiographic abnormalities and COVID-19 clinical outcomes. J Electrocardiol 2023;78:76-79.
- 16. Ocak M, Tascanov MB, Yurt NŞ, Yurt YC. A new predictor for indicating clinical severity and prognosis in COVID-19 patients: Frontal QRS-T angle. Am J Emerg Med 2021;50:631-635.
- 17. Gunduz R, Yildiz BS, Ozgur S, Ozen MB, Bakir EO, Ozdemir IH, Cetin N, Usalp S, Duman S. Frontal QRS/T angle can predict mortality in COVID-19 patients. Am J Emerg Med 2022;58:66- 72.
- 18. Tastan E, İnci Ü. The relationship between in-hospital mortality and frontal QRS-T angle in patients with COVID-19. Cureus 2022;14(8):e28506.
- 19. Tassone B, Ricchio M, Serapide F, Lionello R, Trecarichi EM, Torti C. Predictivity of frontal QRS-T angle for death in COVID-19 patients may differ by age. Am J Emerg Med 2022;57:230-233.
- 20. Magadum A, Kishore R. Cardiovascular Manifestations of COVID-19 Infection. Cells 2020;9(11):2508.
- 21. Salameh A, Zöbisch H, Schröder B, Vigelahn J, Jahn M, Abraham G, Seeger J, Dähnert I, Dhein S. Effects of hypoxia and acidosis on cardiac electrophysiology and hemodynamics. Is NHE-inhibition by cariporide still advantageous? Front Physiol 2020;11:224.
- 22. Kuyumcu MS, Özbay MB, Özen Y, Yayla Ç. Evaluation of frontal plane QRS-T angle in patients with slow coronary flow. Scand Cardiovasc J 2020;54(1):20-25.
- 23. Westgren M, Divon M, Greenspoon J, Paul R. Missing hospital records: a confounding variable in retrospective studies. Am J Obstet Gynecol 1986;155(2):269-271.
SARS-CoV 2 Enfeksiyonlu Hastalarda Kısa Dönem Mortaliteyi Tahmin Etmede Frontal QRS-T Açısı: Bir Analitik Çalışma
Abstract
Amaç: Çalışmada frontal QRS-T açısının mortalite ile ilişkisi ve mortaliteyi tahmin etme yeteneği
araştırıldı.
Gereç ve Yöntemler: Bu retrospektif çalışma, bir eğitim hastanesinde 01/01/2021 ile 07/01/2021
tarihleri arasında acil servise başvuran SARS-CoV 2 enfekte hastaları ile yapılmıştır. Hastalar hayatta measkalan
olarak gruplandırıldı ve 30 günlük tüm nedenlere bağlı ölüm verilerine göre öldü. Gruplar, komorbiditeler, demografik özellikler,
laboratuvar parametreleri ve EKG bulguları temelinde eşleştirildi. Frontal QRS-T açısının kısa dönem mortaliteyi tahmin etme yeteneğinin
değerlendirilmesinde alıcı işletim karakteristik incelemesi kullanıldı.
Bulgular: Frontal QRS-T açısı ölen grupta yaşayanlara göre daha büyüktü (53 (25,5-115,5) ve 28 (13-52) p< 0,001). Alıcı işletim karakteristik
analizine göre frontal QRS- için kesme değeri ve eğri altında kalan alan sırasıyla 41,5 (duyarlılık: %62,2, özgüllük: %64,7) ve 0,659 (%95
güven aralığı: 0,606-0,713) olarak belirlendi. Otuz günlük mortalite için frontal QRS-T açısı (≥41,5) olasılık oranı 3,03 olarak belirlendi (%95
güven aralığı: 2,08-4,42).
Sonuç: Frontal QRS-T açısı, acil serviste SARS-CoV 2 enfeksiyonu olan hastalarda kısa dönem mortalite için yüksek özgüllüğe sahip bir
belirleyicidir.
References
- 1. Mahinrad S, Ferguson I, Macfarlane PW, Clark EN, Stott DJ, Ford I, Mooijaart SP, Trompet S, van Heemst D, Jukema JW, Sabayan B. Spatial QRS-T Angle and Cognitive Decline in Older Subjects. J Alzheimers Dis. 2019;67(1):279-289.
- 2. Dogan A, Kahraman S. Frontal QRS-T angle predicts coronary atherosclerotic burden in patients with ST segment elevation myocardial infarction. J Electrocardiol. 2020;58:155-159.
- 3. Hayiroglu Mİ, Asarcikli LD, Osken A, Keskin K, Kolak Z, Unal S. Frontal QRS-T angle may predict reverse dipping pattern in masked hypertensives. Clin Exp Hypertens. 2022;44(4):2043892.
- 4. Oehler A, Feldman T, Henrikson CA, Tereshchenko LG. QRS-T angle: a review. Ann Noninvasive Electrocardiol 2014;19(6):534-542.
- 5. Zadeh B, Wambach JM, Lambers M, Nassenstein K, Jensen CJ, Bruder O. QRS-T-angle in Patients with ST-Segment Elevation Myocardial Infarction (STEMI) - a Comparison with Cardiac Magnetic Resonance Imaging. Int J Med Sci 2020;17(15):2264-2268.
- 6. Özkan A. Evaluation of short-term mortality prediction using initial lactate and NEWS+L at admission in COVID-19 patients. Disaster Med Public Health Prep 2023;17:e333.
- 7. Özdemir S, Algın A, Akça HŞ, Altunok İ, Kokulu K, Eroğlu SE, Aksel G. Predictive ability of the MEWS, REMS, and RAPS in geriatric patients with SARS-CoV-2 infection in the emergency department. Disaster Med Public Health Prep 2022;17:e174.
- 8. Özkan A. Diagnostic accuracy of clinical gestalt of doctors with different experiences in COVID-19 suspected patients. J Exp Clin Med 2022;39(3):738-742.
- 9. Aslaner Ak M, Sahip B, Çelebi G, Horuz E, Ertop Ş. Abnormalities of peripheral blood parameters in hospitalized patients with COVID-19: a temporal change analysis in relation to survival. Med J West Black Sea 2021;5(3):391-400.
- 10. Akça HŞ, Algın A, Özdemir S, Sevimli H, Kokulu K, Eroğlu SE. Comparison of the efficacy of PSI, CURB-65, CALL and BCRSS in predicting prognosis and mortality in COVID-19 patients. J Exp Clin Med 2021;38(4):434-443.
- 11. Yılmam İ, Gegin S. Evaluation of patient characteristics and pandemic management in the first three months of the COVID-19 Pandemic at the. Med J West Black Sea 2021;5(3):386-390.
- 12. Algın A, Özdemir S. Evaluation of the predictability of platelet mass index for short-term mortality in patients with COVID 19: a retrospective cohort study. J Contemp Med 2021;11(5):728- 733.
- 13. Bergamaschi L, D’Angelo EC, Paolisso P, Toniolo S, Fabrizio M, Angeli F, Donati F, Magnani I, Rinaldi A, Bartoli L, Chiti C, Biffi M, Pizzi C, Viale P, Galié N. The value of ECG changes in risk stratification of COVID-19 patients. Ann Noninvasive Electrocardiol 2021;26(3):e12815.
- 14. Chorin E, Dai M, Kogan E, Wadhwani L, Shulman E, Nadeau- Routhier C, Knotts R, Bar-Cohen R, Barbhaiya C, Aizer A, Holmes D, Bernstein S, Spinelli M, Park D, Chinitz L, Jankelson L. Electrocardiographic risk stratification in COVID-19 patients. Front Cardiovasc Med 2021;8:63607
- 15. Jabbari L, Hayati S, Azizkhani L, Tavakol J. Association of electrocardiographic abnormalities and COVID-19 clinical outcomes. J Electrocardiol 2023;78:76-79.
- 16. Ocak M, Tascanov MB, Yurt NŞ, Yurt YC. A new predictor for indicating clinical severity and prognosis in COVID-19 patients: Frontal QRS-T angle. Am J Emerg Med 2021;50:631-635.
- 17. Gunduz R, Yildiz BS, Ozgur S, Ozen MB, Bakir EO, Ozdemir IH, Cetin N, Usalp S, Duman S. Frontal QRS/T angle can predict mortality in COVID-19 patients. Am J Emerg Med 2022;58:66- 72.
- 18. Tastan E, İnci Ü. The relationship between in-hospital mortality and frontal QRS-T angle in patients with COVID-19. Cureus 2022;14(8):e28506.
- 19. Tassone B, Ricchio M, Serapide F, Lionello R, Trecarichi EM, Torti C. Predictivity of frontal QRS-T angle for death in COVID-19 patients may differ by age. Am J Emerg Med 2022;57:230-233.
- 20. Magadum A, Kishore R. Cardiovascular Manifestations of COVID-19 Infection. Cells 2020;9(11):2508.
- 21. Salameh A, Zöbisch H, Schröder B, Vigelahn J, Jahn M, Abraham G, Seeger J, Dähnert I, Dhein S. Effects of hypoxia and acidosis on cardiac electrophysiology and hemodynamics. Is NHE-inhibition by cariporide still advantageous? Front Physiol 2020;11:224.
- 22. Kuyumcu MS, Özbay MB, Özen Y, Yayla Ç. Evaluation of frontal plane QRS-T angle in patients with slow coronary flow. Scand Cardiovasc J 2020;54(1):20-25.
- 23. Westgren M, Divon M, Greenspoon J, Paul R. Missing hospital records: a confounding variable in retrospective studies. Am J Obstet Gynecol 1986;155(2):269-271.
Details
| Primary Language | English |
|---|---|
| Subjects | Emergency Medicine |
| Journal Section | Research Article |
| Authors | |
| Publication Date | August 31, 2023 |
| Acceptance Date | August 26, 2023 |
| Published in Issue | Year 2023 Volume: 7 Issue: 2 |
