#2803 ECG ABNORMALITIES AND MORTALITY IN HEMODIALYSIS PATIENTS

Abstract

Abstract Background and Aims Hemodialysis patients undergo electrocardiogram (ECG) testing for acute events or as a part of the regular workup. It is still unknown whether chronic ECG abnormalities could be considered as a prognostic factor in dialysis patients. This study aims to analyze the association between mortality and ECG abnormalities of the last two years of follow-up of hemodialysis patients. Method This is a retrospective study that included all patients treated with chronic hemodialysis in a single center between January 2002 and December 2021. Patients who had no ECG in their medical file during the last two years of follow-up were excluded. ECGs were interpreted by two physicians. Logistic regression analysis evaluated the association between ECG signs and mortality. The study was approved by the institutional ethics committee and was conducted in accordance with Helsinki Declaration. Results A total of 298 medical files were reviewed, 149 files included an ECG in the last two years of follow-up. Mean age of patients was 67.1 ±13.2 years, 64.4% were males, 54.4% had diabetes, 44.2% had documented coronary artery disease (CAD), 14.8% had chronic or paroxysmal atrial fibrillation. The median left ventricular ejection fraction (LVEF) was 60% [55.5, 64.5]. 55% percent died after a median follow-up of 47 [25, 87] months. Table 1 summarizes the ECG characteristics found among all patients. In the univariate analysis, age, CAD, LVEF, left axis deviation, large QRS, ST depression and first-degree AV block were significantly associated with mortality. After adjustment to age, dialysis vintage, sex, diabetes, CAD and LVEF, we found a significant association between all-cause death and left axis deviation (Table 2). The poor R wave progression was associated with increased sudden cardiac arrest after adjustment to age, dialysis vintage, sex, diabetes and CAD (OR = 2.65, 95%CI 1.01-6.94, p = 0.048). Conclusion This study showed that left axis deviation on ECG of patients treated with chronic hemodialysis is an independent factor associated with increased all-cause mortality after adjustment to demographic and medical factors. Poor R wave progression was associated with sudden cardiac arrest.