Prolonged QT Interval and Troponin Level as Predictors of Clinical Outcome in Spontaneous Intra-cerebral Hemorrhage

Abstract

Abstract Background Spontaneous intracerebral hemorrhage (ICH) accounts for approximately 20% of all strokes among the Western population. Although huge progress has been made in the management of ischemia, ICH remains a major cause of morbidity and mortality worldwide. The case fatality rate of ICH at 1 month is around 10% to 50%, and less than one survivor out of two is independent at 1 year. Aim of this Study to detect the prognostic value of prolonged QTc interval and Troponin level in clinical outcome of patients with spontaneous intracranial hemorrhage. Patients and Methods This prospective randomized observational study was conducted on fifty adult patients, admitted to ICU of Al Arish general hospital, North Sini, Egypt, presented with acute intracranial hemorrhage diagnosed by non-contrast CT brain. Measurement of serum Troponin level was done at admission then after 24 hours. A 12-lead resting ECG examination was done within 30 min of emergency department admission and then after 24 hours. The QT interval was measured manually by a single person, from the onset of the QRS complex to the point at which the T wave ends. It was measured for 3 to 5 consecutive beats and averaged. Lead II was chosen for this purpose as most normal reference ranges are based upon measurements from this limb lead. Full assessment for all patients at discharge from intensive care unit according to modified RANKIN scale (MRS). Results our study showed 43 cases (86%) were diagnosed as intracranial hemorrhage and 7 cases (14%) were diagnosed as subarachnoid hemorrhage and the mean of age was [61.38±6.87]. Hypertension was diagnosed in 40 patients (80%) and diabetes was diagnosed in 20 patients (40%). In this study, long QT syndrome was present in only 21 cases (42%) and troponin elevated in 6 cases only (12%). Conclusion Prolonged QT interval has a poor predictive value of intracranial hemorrhage prognosis. On the other side Troponin has a very significant predictive value of poor prognosis.