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PR interval prolongation and 1-year mortality among emergency department patients : A multicentre transnational cohort study

Vad, Rune ; Larsen, Tobias Malte ; Kildegaard, Helene ; Brabrand, Mikkel ; Lundager Forberg, Jakob LU ; Ekelund, Ulf LU orcid ; Pottegard, Anton and Lassen, Annmarie Touborg (2021) In BMJ Open 11(12).
Abstract

Objectives Emerging evidence supports that PR interval prolongation is associated with increased mortality. However, most previous studies have limited confounder control, and clinical impact in a population of acute ill patients is unknown. The aim of this study was to investigate whether 1-year all-cause mortality was increased in patients presenting with PR interval prolongation in the emergency department (ED). Design and setting We conducted a register-based cohort study in two Swedish and two Danish EDs. We included all adult patients with an ECG performed at arrival to the Danish EDs during March 2013 to May 2014 and Swedish EDs during January 2010 to January 2011. Using propensity score matching, we analysed HR for 1-year... (More)

Objectives Emerging evidence supports that PR interval prolongation is associated with increased mortality. However, most previous studies have limited confounder control, and clinical impact in a population of acute ill patients is unknown. The aim of this study was to investigate whether 1-year all-cause mortality was increased in patients presenting with PR interval prolongation in the emergency department (ED). Design and setting We conducted a register-based cohort study in two Swedish and two Danish EDs. We included all adult patients with an ECG performed at arrival to the Danish EDs during March 2013 to May 2014 and Swedish EDs during January 2010 to January 2011. Using propensity score matching, we analysed HR for 1-year all-cause mortality comparing patients with PR interval prolongation (>200 ms) and normal PR interval (120-200 ms). Participants and results We included 106 124 patients. PR interval prolongation occurred in 8.9% (95% CI 8.7% to 9.0%); these patients were older and had more comorbidity than those with a normal PR interval. The absolute 1-year risk of death was 13% (95% CI 12.3% to 13.7%) for patients with PR interval prolongation and 7.9% (95% CI 7.7% to 8.0%) for those without. After confounder adjustments by propensity score matching, PR interval prolongation showed no association with 1-year mortality with a HR of 1.00 (95% CI 0.93% to 1.08%). Conclusion PR interval prolongation does not constitute an independent risk factor for 1-year mortality in ED patients.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Accident & emergency medicine, Cardiac epidemiology, Epidemiology
in
BMJ Open
volume
11
issue
12
article number
e054238
publisher
BMJ Publishing Group
external identifiers
  • pmid:34907068
  • scopus:85122197721
ISSN
2044-6055
DOI
10.1136/bmjopen-2021-054238
language
English
LU publication?
yes
id
57e590bf-e105-4ecc-a0f5-440541f9e133
date added to LUP
2022-02-04 14:58:51
date last changed
2025-01-03 13:43:18
@article{57e590bf-e105-4ecc-a0f5-440541f9e133,
  abstract     = {{<p>Objectives Emerging evidence supports that PR interval prolongation is associated with increased mortality. However, most previous studies have limited confounder control, and clinical impact in a population of acute ill patients is unknown. The aim of this study was to investigate whether 1-year all-cause mortality was increased in patients presenting with PR interval prolongation in the emergency department (ED). Design and setting We conducted a register-based cohort study in two Swedish and two Danish EDs. We included all adult patients with an ECG performed at arrival to the Danish EDs during March 2013 to May 2014 and Swedish EDs during January 2010 to January 2011. Using propensity score matching, we analysed HR for 1-year all-cause mortality comparing patients with PR interval prolongation (&gt;200 ms) and normal PR interval (120-200 ms). Participants and results We included 106 124 patients. PR interval prolongation occurred in 8.9% (95% CI 8.7% to 9.0%); these patients were older and had more comorbidity than those with a normal PR interval. The absolute 1-year risk of death was 13% (95% CI 12.3% to 13.7%) for patients with PR interval prolongation and 7.9% (95% CI 7.7% to 8.0%) for those without. After confounder adjustments by propensity score matching, PR interval prolongation showed no association with 1-year mortality with a HR of 1.00 (95% CI 0.93% to 1.08%). Conclusion PR interval prolongation does not constitute an independent risk factor for 1-year mortality in ED patients. </p>}},
  author       = {{Vad, Rune and Larsen, Tobias Malte and Kildegaard, Helene and Brabrand, Mikkel and Lundager Forberg, Jakob and Ekelund, Ulf and Pottegard, Anton and Lassen, Annmarie Touborg}},
  issn         = {{2044-6055}},
  keywords     = {{Accident & emergency medicine; Cardiac epidemiology; Epidemiology}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{12}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{PR interval prolongation and 1-year mortality among emergency department patients : A multicentre transnational cohort study}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2021-054238}},
  doi          = {{10.1136/bmjopen-2021-054238}},
  volume       = {{11}},
  year         = {{2021}},
}