Multiple logistic regression analysis of risk factors in elderly pneumonia patients: QTc interval prolongation as a prognostic factor

Abstract

BackgroundAcute pneumonia is a serious problem in the elderly and various risk factors have already been reported, but the involvement of QTc interval prolongation remains uncertain. The aim of this study was to elucidate the prognostic factors for the development of pneumonia in elderly patients and to study the possible involvement of QTc interval prolongation.MethodsThe subjects were 249 hospitalized pneumonia patients more than 65 years old in Aki-Ohta Hospital from January 2010 to December 2013. Community-acquired pneumonia patients and nursing care and healthcare-associated pneumonia patients were included in the study. The pneumonia severity index, vital signs, blood chemistry data and ECG findings were retrospectively compared using multiple logistic regression analysis.Results39 patients died within 30 days from onset. The clinical features related to poor prognosis were: advanced age, past history of cerebral vascular disease and/or diabetes mellitus, decreased serum albumin level, higher CURB-65 or PORT index scores and QTc interval prolongation. Patients showing a prolonged QTc interval had a higher mortality than those with a normal QTc interval. A prolonged QTc interval was not related to serum calcium concentration and/or treatment with QTc prolongation drug, clarithromycin or azithromycin, but related to age, lower albumin concentration and past history of diabetes mellitus.ConclusionsThese findings suggest potential prognostic factors for pneumonia in elderly patients, including a prolonged QTc interval (> 0.44 seconds).

Prevalence and prognostic significance of prolonged QTc interval in emergency medical patients: A prospective observational study

“…[ 17 ] Other studies including study in medical inpatients and study in elderly pneumonia patients did not reveal any association of hypo or hypercalcemia with QTc interval. [ 20 24 ] Of various electrocardiographic abnormalities, LVH was significantly associated with prolonged QTc interval as shown by the previous study which reported LVH as a risk factor for QTc prolongation. [ 25 ] LVH causes altered conduction and ventricular repolarization and QTc prolongation.…”

Nomogram for the prediction of diabetic nephropathy risk among patients with type 2 diabetes mellitus based on a questionnaire and biochemical indicators: a retrospective study

“…Diabetic nephropathy (DN) is one of the most common microvascular complications of diabetes [14]. The incidence of DN in patients with T2DM is 20-40% [15], and DN increases the risk of death in patients with T2DM.…”