Key result
Abnormal ECG findings were present in 78% of acute stroke patients and were associated with a higher mortality rate (17.95%) compared to patients with a normal ECG (9.09%).
Why the study?
What are the common ECG changes in acute stroke patients and how do they relate to mortality?
Observational (n=100)
No
What are the common ECG changes in acute stroke patients and how do they relate to mortality?
Absolute Event Rate: 17.95% vs 9.09%
ECG changes are common in acute stroke and specific patterns (ST-T changes in ischemic, U waves in hemorrhagic) are associated with higher mortality.
ECG abnormalities may flag higher mortality in acute stroke but should not yet change practice; leaves open need for prospective trials.
BACKGROUND: Its being long recognized about the highly debilitating and destructive nature of cerebrovascular accidents (CVAs). Around the world CVAs has posed as a major factor in medical morbidity and mortality. It has thrown up challenges with regards to their medical management and also towards posttreatment rehabilitation. It is well-known that neurologic disorder contributes variously towards varied electrocardiogram (ECG) changes and stroke is no exception. OBJECTIVE: To study the ECG changes and its relation to mortality in cases of CVA. MATERIALS AND METHODS: A total of 100 patients with acute stroke were enrolled in the study. All the 100 patients underwent ECG recording within first 24 h of admission. The patients were divided into ischemic and hemorrhagic group depending on the nature of lesion. RESULTS: Out of 100 cases, 58 were ischemic and 42 were hemorrhagic. The ECG changes were noted in 78 patients. Among the ischemic group, the changes noted in the ECG were: T wave inversion (34.48%), ST segment depression (32.75%), QTc prolongation (29.31%), and presence of U waves (27.58%). In cases of hemorrhagic stroke, it was: T wave inversion (33.33%), arrhythmias (33.33%), U waves (30.95%), and ST segment depression (23.80%). Mortality was higher in patients with ST-T changes in ischemic group (66.66%) and in patients with positive U waves (60%) in hemorrhagic group. CONCLUSION: In acute stroke patients, changes in ECG were commonly seen. The changes varied from T-wave inversion to ST segment depression in ischemic stroke. In hemorrhagic stroke it consisted of T wave inversion and arrhythmias. Overall mortality was high in cases of hemorrhagic compared to ischemic group.
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Purushothaman et al. (2014) conducted an observational in Cerebrovascular accidents (n=100). Abnormal ECG vs. Normal ECG was evaluated on Mortality. Abnormal ECG findings were present in 78% of acute stroke patients and were associated with a higher mortality rate (17.95%) compared to patients with a normal ECG (9.09%).
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