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A20 Repolarization Abnormalities in Non-traumatic Intracranial Hemorrhage – Risk Factors and Effect on One-Year Outcome

Background and Purpose: Electrocardiographic (ECG) abnormalities are frequent in patients with intracranial insult. The aim of this study was to evaluate the repolarization abnormalities in ECG in patients with non-traumatic intracranial hemorrhage requiring intensive care. Methods: This was a prospective, observational clinical study in a university-level intensive care unit. Clinical characteristics, as well as the level of consciousness on admission and findings in primary head computed tomography were recorded. The six day length study period was divided into three two day sections. In each section one twelve-lead ECG was analyzed and the results of standard blood electrolytes and cardiac troponin I (cTnI) tests, as well as the rate of drug infusions were recorded. The one-year functional outcome was determined using the Glasgow Outcome Score. Results: During the two-year period, 108 patients were included in the study. A prolongation of the QTc interval was associated with female gender (&bgr; 24.0, P = 0.009), age (&bgr; -0.7, 0.062), aneurysmatic bleeding (&bgr; 18.8, P = 0.046), cTnI elevation (&bgr; 20.4, P = 0.035) and the use of propofol (&bgr; 29.9, P = 0.001). The predisposing factors for ischemic-like ECG changes were male gender (OR 5.9, P = 0.003) and cTnI elevation (OR 3.6, P = 0.049) while aneurysmatic bleeding was associated with morphological end-repolarization abnormalities (OR 13.0, P = 0.002). Ischemic-like ECG changes were associated with a poor one-year outcome (OR 3.3, P = 0.054). Conclusions: Repolarization abnormalities are frequent in all types of non-traumatic intracranial hemorrhage. Predisposing factors vary depending on the type of ECG abnormality. Ischemic-like ECG changes are risk factors for poor functional outcome.