Investigation of the relationship between the frontal QRS-T angle on the electrocardiogram and in hospital mortality of patients who referred to emergency service monitored observation and were admitted to intensive care

Aim: Follow-up of patients after emergency department monitored observation and admission to intensive care is very important. The mortality rate and its predictors and cut-off values that develop during the follow-up of patients are important in intensive care unit admissions. Frontal QRS-T angle is a parameter that has been widely studied in terms of cardiac mortality and potential. The aim of our study is to investigate the relationship between the frontal QRS-T angle on the admission electrocardiogram and mortality in patients admitted to intensive care units from emergency department monitored observation. Materials and Methods: In our study, patients who were admitted to intensive care with any preliminary diagnosis and were admitted to Uşak Training and Research Hospital Medical Faculty Emergency Department monitored observation between September 1, 2022 and November 1, 2022 were included retrospectively. After excluding patients under the age of 18, patients with trauma, patients with pacemakers, patients with left bundle branch block, and patients with atrial fibrillation, the remaining 188 patients were included in our study. In the final analysis, they were divided into two groups: 36 dead patients and 152 living patients. Frontal QRS-T angle was evaluated between groups. The data of our study were analyzed with the SPSS 22.0 statistical program. Results: The deceased group was statistically older than the surviving group, and there was no significant difference in other parameters (p = 0.06). Frontal QRS-T angle was statistically higher in the deceased group than in the surviving group (p<0.001). In multivariate Cox regression analysis, frontal QRS-T [OR= 1.066(1.019-1.223), p <0.001], CRP [OR=1.005(1.002-1.098), p<0.001] were found to be independent predictors of mortality. In the ROC analysis, the cut-off point for the frontal QRS-T angle was determined as 74.5. an RS duration greater than 74.5; It was analyzed that it predicted mortality in emergency department patients admitted to intensive care with Sensitivity: 79% and Specificity 75% [AUC: 0.820, p<0.001]. Conclusions: Frontal QRS-T, measured on admission to emergency department monitored, is a new cheap, fast and easily obtained ECG parameter that can predict in-hospital mortality and help identify critically ill patients in intensive care follow-up.