Can frontal QRS-T angle predict mortality in patients with severe Crimean-Congo Hemorrhagic Fever?

Abstract

Purpose: This study aims to determine whether frontal QRS-T (fQRS-T) angle measurements assist in predicting prognosis in severe CCHF (Crimean-Congo Hemorrhagic Fever) patients. Material and Method: The study was conducted with 140 intensive care patients diagnosed with CCHF between 01.01.2012 and 2022. Demographic data and length of stay were recorded. In addition, laboratory data were recorded, including hemoglobin, troponin T, C-reactive protein, lymphocyte numbers, neutrophil, and platelet. fQRS-T angles were measured on electrocardiographic (ECG) data of the patients. Results: The mean fQRS-T angle was 53.9°±29.3° in non-survivors and 34.2°±17.3° in the survivors (p<0.001). Regarding non-survivors, they were older, and their hemoglobin, platelet and lymphocyte levels were lower (p<0.001), and their QRS durations were broader (p=0.021) than survivors. The fQRS-T angle cutoff value in predicting mortality was determined as 41.5°. For fQRS-T ≥41.5°, specificity was 61.1%, and sensitivity was 80.9% (area under the curve: 0.711, 95% CI: 0.624–0.798, p<0.001). Conclusion: Current study's results showed the usability of the fQRS-T angle as an inexpensive, convenient, strong, and repeatable predictor to determine the prognosis of CCHF patients. A detailed electrocardiographic evaluation in the routine follow-up of high-risk CCHF patients may indicate the prognosis of the disease.

Keywords

• QRS-T angle
• Crimean-Congo Hemorrhagic Fever
• mortality
• prognosis

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