Key result
Polypharmacy linked to ~328% higher odds of TdP-risk medication use in critically ill patients.
Why the study?
Critically ill patients are especially vulnerable to drug-induced QTc prolongation and Torsade de Pointes, but data on TdP-associated medication prescribing and risk factors were needed in Jordan.
What is the prevalence and what are the predictors of prescribing QTc-prolonging medications in critically ill patients?
Cross-Sectional (n=13,300)
No
What is the prevalence and what are the predictors of prescribing QTc-prolonging medications in critically ill patients?
Answers are grounded in this paper and cite their sources.
A significant proportion of critically ill patients are prescribed medications with known QTc prolongation risk, with polypharmacy being a major predictor.
Background: Acquired prolonged corrected QT (QTc) interval can lead to life-threatening Torsade de Pointes (TdP) arrhythmia. Multiple risk factors including medications, comorbidities, and electrolyte imbalances contribute significantly to acquired manifestations of the QTc prolongation. Critically ill patients are particularly more vulnerable to TdP due to complex medical conditions, aging, and polypharmacy. Objective: This study aimed to assess the prevalence of TdP-associated medication prescribing, identify risk factors for QTc prolongation and TdP, and determine primary predictors of high TdP medication usage in critically ill patients in Jordan. Methods: We conducted a retrospective cross-sectional analysis of electronic medical records for patients from King Abdullah University Hospital who were admitted to Intensive Care Unit (ICU) between (July 2012-July 2022). We collected data on patients’ demographics, clinical characteristics, comorbidities, laboratory results, and prescribed medications. Medications were categorized into three TdP risk levels according to CredibleMeds ® assessment tool. Data were analyzed using descriptive statistics and a binary logistic regression model. Results: Of the 13,300 patients (58.2% male, median age 62 years). Prescribing prevalence for medications with known TdP risk was 19%, possible risk (24.7%), conditional risk (21.6%), and confirmed conditional risk (8.3%). Common comorbidities included hypertension (40.9%), diabetes (33.3%), and cancer (15.4%). Drugs with known TdP risk included citalopram, amiodarone, clarithromycin, and ciprofloxacin. A binary regression model revealed that as age increased, the odds of TdP associated medication prescribing decreased (OR = 0.989, p < 0.001), while patients on more than five medications had higher odds (OR = 4.281, p < 0.001). Conclusion: The study identified a notable prevalence of prescribing for medications with QTc prolongation/TdP risk in critically ill patients. Healthcare providers in the ICU should exercise caution to minimize the inadvertent prescription of TdP associated medications especially among older patients and those with polypharmacy.
No takes yet. Share an insight, caveat, or question.
Al‐Azayzih et al. (2024) conducted a cross-sectional in Critically ill patients (n=13,300). Medications with QTc prolongation/TdP risk was evaluated on Prevalence of TdP-associated medication prescribing. Prescribing prevalence for medications with known TdP risk was 19% among critically ill patients, with polypharmacy (>5 medications) significantly increasing the odds of usage (OR 4.281, p<0.001).
Synapse has enriched 10 related papers. Consider them for comparative context: