PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort study

Objectives Emerging evidence supports that PR interval prolongation is associated with increased mortality. However, most previous studies have limited confounder control, and clinical impact in a population of acute ill patients is unknown. The aim of this study was to investigate whether 1-year al...

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Main Authors: Annmarie Touborg Lassen, Jakob Lundager Forberg, Anton Pottegård, Ulf Ekelund, Mikkel Brabrand, Rune Vad, Tobias Malte Larsen, Helene Kildegaard
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/12/e054238.full
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author Annmarie Touborg Lassen
Jakob Lundager Forberg
Anton Pottegård
Ulf Ekelund
Mikkel Brabrand
Rune Vad
Tobias Malte Larsen
Helene Kildegaard
author_facet Annmarie Touborg Lassen
Jakob Lundager Forberg
Anton Pottegård
Ulf Ekelund
Mikkel Brabrand
Rune Vad
Tobias Malte Larsen
Helene Kildegaard
author_sort Annmarie Touborg Lassen
collection DOAJ
description Objectives Emerging evidence supports that PR interval prolongation is associated with increased mortality. However, most previous studies have limited confounder control, and clinical impact in a population of acute ill patients is unknown. The aim of this study was to investigate whether 1-year all-cause mortality was increased in patients presenting with PR interval prolongation in the emergency department (ED).Design and setting We conducted a register-based cohort study in two Swedish and two Danish EDs. We included all adult patients with an ECG performed at arrival to the Danish EDs during March 2013 to May 2014 and Swedish EDs during January 2010 to January 2011. Using propensity score matching, we analysed HR for 1-year all-cause mortality comparing patients with PR interval prolongation (>200 ms) and normal PR interval (120–200 ms).Participants and results We included 106 124 patients. PR interval prolongation occurred in 8.9% (95% CI 8.7% to 9.0%); these patients were older and had more comorbidity than those with a normal PR interval. The absolute 1-year risk of death was 13% (95% CI 12.3% to 13.7%) for patients with PR interval prolongation and 7.9% (95% CI 7.7% to 8.0%) for those without. After confounder adjustments by propensity score matching, PR interval prolongation showed no association with 1-year mortality with a HR of 1.00 (95% CI 0.93% to 1.08%).Conclusion PR interval prolongation does not constitute an independent risk factor for 1-year mortality in ED patients.
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spelling doaj-art-57eee0990b6f47e8b502c4f5046bc7552024-12-10T10:05:09ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-054238PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort studyAnnmarie Touborg Lassen0Jakob Lundager Forberg1Anton Pottegård2Ulf Ekelund3Mikkel Brabrand4Rune Vad5Tobias Malte Larsen6Helene Kildegaard7Department of Clinical Research, University of Southern Denmark, Odense, DenmarkDepartment of Emergency Medicine and Prehospital Care, Helsingborgs lasarett, Helsingborg, SwedenClinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, DenmarkDepartment of Emergency Medicine, Lunds Universitet, Lund, SwedenDepartment of Clinical Research, University of Southern Denmark, Odense, DenmarkDepartment of Emergency Medicine, Odense University Hospital, Odense, Syddanmark, DenmarkDepartment of Emergency Medicine, Odense University Hospital, Odense, Syddanmark, DenmarkClinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, DenmarkObjectives Emerging evidence supports that PR interval prolongation is associated with increased mortality. However, most previous studies have limited confounder control, and clinical impact in a population of acute ill patients is unknown. The aim of this study was to investigate whether 1-year all-cause mortality was increased in patients presenting with PR interval prolongation in the emergency department (ED).Design and setting We conducted a register-based cohort study in two Swedish and two Danish EDs. We included all adult patients with an ECG performed at arrival to the Danish EDs during March 2013 to May 2014 and Swedish EDs during January 2010 to January 2011. Using propensity score matching, we analysed HR for 1-year all-cause mortality comparing patients with PR interval prolongation (>200 ms) and normal PR interval (120–200 ms).Participants and results We included 106 124 patients. PR interval prolongation occurred in 8.9% (95% CI 8.7% to 9.0%); these patients were older and had more comorbidity than those with a normal PR interval. The absolute 1-year risk of death was 13% (95% CI 12.3% to 13.7%) for patients with PR interval prolongation and 7.9% (95% CI 7.7% to 8.0%) for those without. After confounder adjustments by propensity score matching, PR interval prolongation showed no association with 1-year mortality with a HR of 1.00 (95% CI 0.93% to 1.08%).Conclusion PR interval prolongation does not constitute an independent risk factor for 1-year mortality in ED patients.https://bmjopen.bmj.com/content/11/12/e054238.full
spellingShingle Annmarie Touborg Lassen
Jakob Lundager Forberg
Anton Pottegård
Ulf Ekelund
Mikkel Brabrand
Rune Vad
Tobias Malte Larsen
Helene Kildegaard
PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort study
BMJ Open
title PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort study
title_full PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort study
title_fullStr PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort study
title_full_unstemmed PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort study
title_short PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort study
title_sort pr interval prolongation and 1 year mortality among emergency department patients a multicentre transnational cohort study
url https://bmjopen.bmj.com/content/11/12/e054238.full
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