ELECTROCARDIOGRAPHIC PREDICTORS OF MORTALITY IN ACUTE STROKE

Abstract

Objectives; The study is aimed at establishing the prognostic importance of various ECG changes as predictors of in-hospital mortality from acute stroke. Study Design; Cross-Sectional. Patients and methods; Two hundred patients of acute stroke who presented within 48-hours of the onset of neurological symptoms, were enrolled in the study, irrespective of the comorbid conditions like hypertension, diabetes mellitus, valvular heart disease, coronary artery disease and cardiomyopathy. A non-contrast computerized tomographic scan (CT Scan) of the brain and a 12-lead ECG were recorded at the time of admission to define the stroke type and to determine the ECG variables. A follow-up of the patients was recorded during their stay in the Medical Department for calculating in hospital mortality. The ECG variables categorized as, disturbances of heart rate and rhythm, ischemic changes and heart rate corrected QT interval (QTc interval), were correlated with the death during the hospital stay, by analyzing the data using SPSS-20 version for statistical analysis. Results; Majority of the patients had ischemic stroke, while mortality was higher with hemorrhagic stroke. ECG changes due to variations in heart rate and rhythm were frequent but less helpful than ischemic changes and QTc alterations, in predicting in hospital deaths due to stroke.  Conclusion; In hospital mortality in sufferers of stroke is mostly of cardiac origin. Electrocardiographic changes resulting from QTc prolongation, ischemic changes, and rhythm disturbances are most helpful in this regard.

Keywords; ECG, CT-Scan, QTc interval