QTc, Tp-e Interval and Tp-e/QTc Ratio in Patients with Hypocalcemia-case Control Study

Abstract Background: To the best of our knowledge, there are studies related to QT and QTc interval in patients with hypocalcemia, but there are no studies evaluating T wave peak and end interval (Tp-e interval), Tp-e/QT and Tp-e/QTc ratios used to evaluate cardiac arrhythmia risk and ventricular repolarization changes rates. Objectives: Therefore, we aimed to investigate whether there is a change in Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in patients with hypocalcemia. Methods: Retrospectively, 29 patients with hypocalcemia in the emergency department were included in the study. Twenty-nine patients with similar age and sex distribution were included in the study as the control group. All patients underwent 12-lead electrocardiography (ECG). In addition to routine measurements, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were measured on ECG. The study data were grouped as patients with and without hypocalcemia. Results: The mean age of the patients was 66.24 ± 4.95 years. QTc interval, Tp-e interval and Tp-e/QTc values were found to be significantly higher in patients with hypocalcemia (p <0.001 for each). QTc interval, Tp-e interval and Tp-e/QTc ratio showed a significant negative correlation with calcium levels. Conclusion: Tp-e interval and Tp-e/QTc ratios are significantly increased in patients with hypocalcemia compared to those without hypocalcemia and this can be used more effectively in the follow-up of cardiac fatal arrhythmias.

Evaluation of the frequency of patients with cancer presenting to an emergency department

SUMMARY OBJECTIVE: This study aims to determine the demographic characteristics of cancer patients admitted to an emergency department and determine the relationship between the frequency of admission to the emergency department and oncological emergencies and their effect on mortality. METHODS: This observational, prospective, diagnostic accuracy study was performed in the ED of a tertiary care hospital. Patients over the age of 18 who were previously diagnosed with cancer and admitted to the emergency service for medical reasons were included in the study. We recorded baseline characteristics including age, gender, complaints, oncological diagnosis, metastasis status, cancer treatments received, the number of ED admissions, structural and metabolic oncological emergency diagnoses in the ED, discharge status, length of hospital stay, and mortality status. RESULTS: In our study, 1205 applications related to the oncological diagnosis of 261 patients were examined. 55.6% of the patients were male, and 44.4% were female. The most common metabolic oncological emergency was anemia (19.5%), and the most common structural oncological emergency was bone metastasis-fracture (4.6%.) The mean score of admission of patients to the emergency department was four times (min: 1 max: 29) during the study period. A total of 49.4% (n: 129) of the patients included in the study died during follow-up, and the median time of death was 13 days after the last ED admission. CONCLUSION: The palliation of patient symptoms in infusion centers that will be established in the palliative care center will contribute to the decrease in the frequency of use of emergency services.

RESUMO OBJETIVO: Este estudo tem como objetivo determinar as características demográficas dos pacientes com câncer admitidos no setor de emergência e determinar a relação entre a frequência de admissão no setor de emergência e emergências oncológicas e seus efeitos na mortalidade. MÉTODOS: Este estudo observacional, prospectivo e de precisão diagnóstica foi realizado no pronto-socorro de um hospital terciário. Pacientes com idade superior a 18 anos que foram previamente diagnosticados com câncer e admitidos no serviço de emergência por razões médicas foram incluídos no estudo. Registramos características basais, incluindo idade, sexo, queixas, diagnóstico oncológico, status de metástase, tratamentos de câncer recebidos, número de admissões ao DE, diagnósticos de emergência oncológicos estruturais e metabólicos no DE, status de alta, tempo de internação e estado de mortalidade. RESULTADOS: Em nosso estudo, foram examinadas 1205 aplicações relacionadas ao diagnóstico oncológico de 261 pacientes. 55,6% dos pacientes eram do sexo masculino e 44,4% eram do sexo feminino. A emergência oncológica metabólica mais comum foi anemia (19,5%) e a emergência oncológica estrutural mais comum foi fratura óssea causada por metástase (4,6%). A média de admissão dos pacientes no pronto-socorro foi de quatro vezes (min: 1 máx: 29) durante o período do estudo. Um total de 49,4% (n: 129) dos pacientes incluídos no estudo morreram durante o acompanhamento, e a mediana para o tempo de morte foi de 13 dias após a última admissão ao ED. CONCLUSÃO: A paliação dos sintomas de pacientes nos centros de infusão que serão estabelecidos nos centros de cuidados paliativos contribuirá para a diminuição da frequência de uso dos serviços de emergência.