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Can the ECG be used to estimate age-related survival?

Kellett, J ; Bogh, S B ; Ekelund, U LU orcid and Brabrand, M (2022) In QJM - Monthly Journal of the Association of Physicians 115(5). p.298-303
Abstract

BACKGROUND: There are few reports of the relationship between electrocardiogram (ECG) findings and the age-related survival of acutely ill patients.

AIM: This study compared the 1-year survival curves of patients attending two Danish emergency departments (EDs) with normal and abnormal ECGs. Patients were divided into age groups from 20 to 90 years of age, and an abnormal ECG was defined as low QRS voltage (i.e. lead I + II <1.4 mV) or QTc interval prolongation >434 ms.

METHODS: A retrospective register-based observational study on 35 496 patients attending two Danish EDs, with 100% follow-up for 1 year.

RESULTS: ECG abnormality increases linearly with age, and between 30 and 70 years of age. Patients aged 20-29... (More)

BACKGROUND: There are few reports of the relationship between electrocardiogram (ECG) findings and the age-related survival of acutely ill patients.

AIM: This study compared the 1-year survival curves of patients attending two Danish emergency departments (EDs) with normal and abnormal ECGs. Patients were divided into age groups from 20 to 90 years of age, and an abnormal ECG was defined as low QRS voltage (i.e. lead I + II <1.4 mV) or QTc interval prolongation >434 ms.

METHODS: A retrospective register-based observational study on 35 496 patients attending two Danish EDs, with 100% follow-up for 1 year.

RESULTS: ECG abnormality increases linearly with age, and between 30 and 70 years of age. Patients aged 20-29 years with ECG abnormalities are more than four times more likely to die within a year than patients of the same age with a normal ECG. An individual with an abnormal ECG has the same risk of dying within a year as an individual with a normal ECG who is 10 years older. After 70 years of age this tight relationship ends, but for younger individuals with an abnormal ECG the increase in mortality is even higher.

CONCLUSION: An ECG may be a simple practical estimate of age-related survival. For a patient under 70 years, an abnormal QRS voltage or a prolonged QTc interval may increase 1-year mortality to that of a patient ∼10 years older.

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Please use this url to cite or link to this publication:
author
; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Adult, Aged, Arrhythmias, Cardiac, Electrocardiography, Emergency Service, Hospital, Humans, Long QT Syndrome, Middle Aged, Retrospective Studies
in
QJM - Monthly Journal of the Association of Physicians
volume
115
issue
5
pages
6 pages
publisher
Oxford University Press
external identifiers
  • scopus:85129999621
  • pmid:33970281
ISSN
0033-5622
DOI
10.1093/qjmed/hcab134
language
English
LU publication?
no
additional info
© The Author(s) 2021. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com.
id
427e9cad-86b3-4486-97f2-21831f6c04ca
date added to LUP
2022-09-29 20:56:44
date last changed
2024-03-21 14:16:56
@article{427e9cad-86b3-4486-97f2-21831f6c04ca,
  abstract     = {{<p>BACKGROUND: There are few reports of the relationship between electrocardiogram (ECG) findings and the age-related survival of acutely ill patients.</p><p>AIM: This study compared the 1-year survival curves of patients attending two Danish emergency departments (EDs) with normal and abnormal ECGs. Patients were divided into age groups from 20 to 90 years of age, and an abnormal ECG was defined as low QRS voltage (i.e. lead I + II &lt;1.4 mV) or QTc interval prolongation &gt;434 ms.</p><p>METHODS: A retrospective register-based observational study on 35 496 patients attending two Danish EDs, with 100% follow-up for 1 year.</p><p>RESULTS: ECG abnormality increases linearly with age, and between 30 and 70 years of age. Patients aged 20-29 years with ECG abnormalities are more than four times more likely to die within a year than patients of the same age with a normal ECG. An individual with an abnormal ECG has the same risk of dying within a year as an individual with a normal ECG who is 10 years older. After 70 years of age this tight relationship ends, but for younger individuals with an abnormal ECG the increase in mortality is even higher.</p><p>CONCLUSION: An ECG may be a simple practical estimate of age-related survival. For a patient under 70 years, an abnormal QRS voltage or a prolonged QTc interval may increase 1-year mortality to that of a patient ∼10 years older.</p>}},
  author       = {{Kellett, J and Bogh, S B and Ekelund, U and Brabrand, M}},
  issn         = {{0033-5622}},
  keywords     = {{Adult; Aged; Arrhythmias, Cardiac; Electrocardiography; Emergency Service, Hospital; Humans; Long QT Syndrome; Middle Aged; Retrospective Studies}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{298--303}},
  publisher    = {{Oxford University Press}},
  series       = {{QJM - Monthly Journal of the Association of Physicians}},
  title        = {{Can the ECG be used to estimate age-related survival?}},
  url          = {{http://dx.doi.org/10.1093/qjmed/hcab134}},
  doi          = {{10.1093/qjmed/hcab134}},
  volume       = {{115}},
  year         = {{2022}},
}