QTc prolongation in pediatric patients with diabetic ketoacidosis

dc.contributor.authorQuigley, Leanne
dc.contributor.authorPerez, Michelle M
dc.contributor.authorMedar, Shivanand
dc.contributor.authorClark, Bradley C.
dc.contributor.orcid0000-0002-3676-4083en_US
dc.date.accessioned2023-10-26T20:35:02Z
dc.date.available2023-10-26T20:35:02Z
dc.date.issued2021
dc.descriptionScholarly articleen_US
dc.description.abstract_Objective_ To investigate the association between diabetic ketoacidosis (DKA) and prolonged QTc interval and to assess for correlation between DKA severity and QTc prolongation. _Study design_ Retrospective observational study in a pediatric hospital. Patients admitted with DKA diagnosed by laboratory criteria and an electrocardiogram (ECG) performed during a period of acidosis were identified using Looking Glass Clinical Analytics. Data including age, sex, pH, electrolytes, anion gap, and ECG variables were collected. Patients were excluded if they had a prior diagnosis of prolonged QTc or were taking QTc prolonging medications. Severity of DKA was classified as mild (pH 7.24-7.3), moderate (pH 7-7.24), or severe (pH <7). ECGs were read by a pediatric electrophysiologist and QTc interval was manually calculated utilizing the Bazett formula. _Results_ Ninety-six patients were included (mean age 15.2 4.2 years, pH 7.12 0.12, bicarbonate 8.6 ±3.7 mmol/L, potassium 5.3 ± 1.1 mEq/L). Mean QTc interval for all patients in DKA was 454 ± 32 msec. Mean QTc in the mild group was 441 ± 22 msec, moderate group 460 ±36 msec, and severe group 461 ± 34 msec. There was a significant difference in QTc interval across DKA severity groups (P = .05). There was a significant association between higher anion gaps and greater QTc intervals (r = 0.21, P = .04). _Conclusions_ Thirty-one percent of pediatric patients with DKA demonstrated QTc prolongation on ECG. Severity of DKA and worsening acidosis were associated with increased prolongation of the QTc. Further study is required to evaluate the clinical impact of these findings. (J Pediatr 2021;228:235-9).en_US
dc.identifier.citationPerez, M. M., Medar, S., Quigley, L., & Clark, B. C. (2021). QTc prolongation in pediatric patients with diabetic ketoacidosis. The Journal of Pediatrics, 228, 235-239.en_US
dc.identifier.doihttps://doi.org/10.1016/j.jpeds.2020.08.085en_US
dc.identifier.issn0022-3476 (print) 1097-6833 (online)
dc.identifier.urihttps://www-sciencedirect-com.ezproxy.yu.edu/science/article/pii/S0022347620311215en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12202/9382
dc.language.isoen_USen_US
dc.publisherMosbyen_US
dc.relation.ispartofseriesThe Journal of Pediatrics;228
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
dc.subjectdiabetic ketoacidosis (DKA)en_US
dc.subjectQTc prolongation.en_US
dc.subjectelectrocardiographyen_US
dc.subjectpediatricsen_US
dc.subjectcritical careen_US
dc.subjectdiabetesen_US
dc.subjectmellitusen_US
dc.subjectcardiologyen_US
dc.titleQTc prolongation in pediatric patients with diabetic ketoacidosisen_US
dc.typeArticleen_US
local.yu.facultypagehttps://www.yu.edu/faculty/pages/quigley-leanneen_US

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