Screening entire health system ecg databases to identify patients at increased risk of death

David G. Strauss, Nathan Mewton, Richard L. Verrier, Bruce D. Nearing, Francis E. Marchlinski, Tony Killian, John Moxley, Larisa Tereshchenko, Katherine C. Wu, Raimond Winslow, Christopher Cox, Peter M. Spooner, João A C Lima

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background-Current methods to identify patients at higher risk for sudden cardiac death, primarily left ventricular ejection fraction =35%, miss ̃80% of patients who die suddenly. We tested the hypothesis that patients with elevated QRS-scores (index of myocardial scar) and wide QRS-T angles (index abnormal depolarization-repolarization relationship) have high 1-year all-cause mortality and could be further risk stratified with clinical characteristics. Methods and Results-We screened all 12-lead ECGs over 6 months at 2 large hospital systems and analyzed clinical characteristics and 1-year mortality. Patients with ECGs obtained in hospital areas with known high mortality rates were excluded. At the first hospital, QRS-score =5 and QRS-T angle =105° identified 8.0% of patients and was associated with an odds ratio of 2.79 (95% confidence interval, 2.10-3.69) for 1-year mortality compared with patients below both ECG thresholds (13.9% versus 5.5% death rate). Left ventricular ejection fraction was >35% in 82% of the former group of patients, and addition of ECG measures to left ventricular ejection fraction increased the discrimination of death risk (P

Original languageEnglish (US)
Pages (from-to)1156-1162
Number of pages7
JournalCirculation: Arrhythmia and Electrophysiology
Volume6
Issue number6
DOIs
StatePublished - Dec 2013
Externally publishedYes

Fingerprint

Databases
Health
Electrocardiography
Mortality
Stroke Volume
Sudden Cardiac Death
Cicatrix
Odds Ratio
Confidence Intervals

Keywords

  • Arrhythmias
  • Cardiac
  • Death
  • Electrocardiography
  • Fibrosis
  • Mass screening

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Strauss, D. G., Mewton, N., Verrier, R. L., Nearing, B. D., Marchlinski, F. E., Killian, T., ... Lima, J. A. C. (2013). Screening entire health system ecg databases to identify patients at increased risk of death. Circulation: Arrhythmia and Electrophysiology, 6(6), 1156-1162. https://doi.org/10.1161/CIRCEP.113.000411

Screening entire health system ecg databases to identify patients at increased risk of death. / Strauss, David G.; Mewton, Nathan; Verrier, Richard L.; Nearing, Bruce D.; Marchlinski, Francis E.; Killian, Tony; Moxley, John; Tereshchenko, Larisa; Wu, Katherine C.; Winslow, Raimond; Cox, Christopher; Spooner, Peter M.; Lima, João A C.

In: Circulation: Arrhythmia and Electrophysiology, Vol. 6, No. 6, 12.2013, p. 1156-1162.

Research output: Contribution to journalArticle

Strauss, DG, Mewton, N, Verrier, RL, Nearing, BD, Marchlinski, FE, Killian, T, Moxley, J, Tereshchenko, L, Wu, KC, Winslow, R, Cox, C, Spooner, PM & Lima, JAC 2013, 'Screening entire health system ecg databases to identify patients at increased risk of death', Circulation: Arrhythmia and Electrophysiology, vol. 6, no. 6, pp. 1156-1162. https://doi.org/10.1161/CIRCEP.113.000411
Strauss, David G. ; Mewton, Nathan ; Verrier, Richard L. ; Nearing, Bruce D. ; Marchlinski, Francis E. ; Killian, Tony ; Moxley, John ; Tereshchenko, Larisa ; Wu, Katherine C. ; Winslow, Raimond ; Cox, Christopher ; Spooner, Peter M. ; Lima, João A C. / Screening entire health system ecg databases to identify patients at increased risk of death. In: Circulation: Arrhythmia and Electrophysiology. 2013 ; Vol. 6, No. 6. pp. 1156-1162.
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