Retrospective evaluation of laboratory, electrocardiographic and imaging findings of patients with anemia admitted to the Suleyman Demirel University Emergency Dempartment

Objective: The aim of our study was to investigate the variation of the frontal QRS-T angle in patients with anemia, its effect on the depth of anemia and mortality, the effect of erythrocyte suspension replacement on the angle, and the relationship between this angle and cardiothoracic ratio. Materials and Methods: Our study was conducted retrospectively, randomized and single-center on 250 patients with a diagnosis of anemia who were admitted to the Emergency Department of Süleyman Demirel University Faculty of Medicine Hospital between 01.01.2023-01.01.2024 and had complete data in the system. Patients' age, hemogram parameters, CTO measurement values in PAAC graphy, ECG parameters, ES replacement status were recorded. The 1-year outcome of the patients was followed up. Results: In our study, 250 patients with anemia were analyzed. 46.4% (n=116) were male and 53.6% (n=134) were female. According to 1-year mortality, 18% (n=45) patients were exited and 82% (n=205) patients were alive. When subgroups were evaluated according to anemia severity, 30.4% (n=76) had mild anemia, 43.6% (n=109) had moderate anemia, 26% (n=65) had profound anemia. When classified according to MCV values, 35% (n=86) had microcytic anemia, 62% (n=156) had normocytic anemia, 3% (n=8) had macrocytic anemia. When divided according to transfusion status, 59.2% (n=148) received erythrocyte replacement and 40.8% (n=102) did not receive erythrocyte replacement. In our study, pulse rate, QTc duration and frontal QRS-T angle were found to be significant according to outcome (p: 0.019, 0.015, 0.025). When analyzed according to mortality, a significant difference was observed in MCV subgroups and ES replacement status (p: 0.007, <0.001) In our study, the cut-off value of the frontal QRS-T angle was determined as 147 and mortality was significantly increased in patients above this value (p: 0.037). When the effect of FQRS-T angle on overall mortality was analyzed, statistical significance was found according to one-year survival according to the predetermined cut-off value of the frontal QRS-T angle (Log Ranke Mantel cox= <0.001). When one-year survival was analyzed, it was observed that approximately 45% mortality rate was observed in patients with an angle value above 147, while approximately 15% mortality rate was observed in patients with an angle value below 147. Conclusion: Our study demonstrated that the frontal QRS-T angle may contribute to the prediction of cardiac risks, prognosis and mortality in the early period of anemia patients. Keywords: Anemia, Hemoglobin, Frontal QRS-T angle, Cardiothoracic ratio, ES replacement, QTc duration, Mortality