Key result
A marked shift of the axis of the mean QRS vector to the right on serial ECG was associated with a bad prognosis, particularly death, in patients with severe kwashiorkor.
Why the study?
Does a shift in the mean QRS vector on ECG predict prognosis in patients with severe kwashiorkor?
Observational (n=44)
Does a shift in the mean QRS vector on ECG predict prognosis in patients with severe kwashiorkor?
A rightward shift of the mean QRS vector axis on ECG may serve as a useful prognostic guide for deterioration or death in patients with severe kwashiorkor.
May aid risk stratification in severe kwashiorkor; leaves open need for prospective validation before guiding care.
Serial ECG studies were carried out on 32 cases of severe kwashiorkor and two cases of marasmus. Single readings were also carried out on 10 controls. In those cases which had a bad prognosis, particularly those that died, there was a marked shift of the axis of the mean QRS vector of the limb leads to the right. Those that did not deteriorate showed no such shift, and those that deteriorated but eventually recovered, showed a shift to the left in the recovery phase. No such shift was noted in the two cases of marasmus. I suggest that this shift in mean QRS vector could be a useful and accurate prognostic guide.
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A. J. H. Stephens (1975) conducted an observational in Severe kwashiorkor (n=44). Rightward shift of the mean QRS vector axis on ECG vs. No shift or leftward shift on ECG was evaluated on Prognosis (deterioration or death). A marked shift of the axis of the mean QRS vector to the right on serial ECG was associated with a bad prognosis, particularly death, in patients with severe kwashiorkor.
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