Traumatic subarachnoid hemorrhage and QTc prolongation

Bryan R Collier, S Lee Miller, Gary S Kramer, Jennifer A Balon, Luis S Gonzalez
Journal of Neurosurgical Anesthesiology 2004, 16 (3): 196-200

OBJECTIVE: Spontaneous subarachnoid hemorrhage (SAH) causes a prolonged corrected QT interval (QTc) in 25% to 90% of patients, but whether this occurs with traumatic SAH (tSAH) is unknown. This investigation was conducted to determine whether QTc prolongation occurs with tSAH and to evaluate QTc prolongation with respect to severity of tSAH.

DESIGN: Records of 104 consecutive tSAH patients were reviewed. A QTc was calculated on posttrauma day (PTD) 0, 1, and 3. Cranial computed tomography (CT) scans were graded for severity using a previously validated scale. QTc intervals were compared based on CT scan severity.

SETTING: Pennsylvania level II trauma center.

PATIENTS: Trauma patients with tSAH.


MEASUREMENTS AND MAIN RESULTS: QTc prolongation occurred in 67% of those with tSAH. Mean QTc intervals for PTD0, PTD1, and PTD3 were 470 +/- 69 ms, 467 +/- 72 ms, and 465 +/- 50 ms, respectively. As the severity of the tSAH increased, the average QTc became more prolonged (Pearson's r = 0.855, P = 0.003).

CONCLUSIONS: tSAH is a common cause of an acquired prolonged QTc syndrome. As the tSAH becomes more severe, the QTc becomes more prolonged.

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