Evaluation the relation between QTc-interval, and level of consciousness and pathologic brain CTScan findings in patients who admitted to Tabriz Sina Hospital (2015-2020)

Abstract

Background and purpose: Carbon monoxide (CO) is an odorless, colorless, and toxic gas, representing the most prevalent pollutant in the lower atmosphere. CO poisoning stands as a leading cause of mortality both in Iran and globally. Given the limited available data on the diverse complications associated with CO poisoning, particularly those related to cardiovascular health, this research was undertaken to explore the correlation between QTc-interval, the level of consciousness, and pathological findings observed in brain CT scans among patients hospitalized for carbon monoxide poisoning. Methodology: This cross-sectional study was conducted by gathering crucial information from Sina Hospital in Tabriz. Over a five-year period (1395-1399), data from patients admitted to the poisoning department were scrutinized. The QTc interval was computed and documented from ECGs performed during admission, utilizing the Bazett and Frederica formulas. Statistical analyses were then applied to investigate the correlation between QTc levels and changes in brain CT scans, taking into account the nature of observed changes. Furthermore, the level of consciousness at the time of admission was extracted from patient records based on AVPU and GCS. SPSS statistical software was employed to analyze the statistical relationship between the level of consciousness and QTc values. Lastly, the connection between the level of consciousness and the presence or absence of changes in brain CT scans was explored using SPSS statistical software. Findings: The results of the study showed that the average QTc B = 434.45 and QTc.F = 403.61 miliseconds, and the level of consciousness in patients poisoned with carbon monoxide, according to the UPVA classification, was the highest frequency in the P category (37.2%) and the lowest frequency in the U category (11.6%). And the average level of consciousness in patients poisoned with carbon monoxide according to GSC is 10.52. Also, the examination of CT Scan of patients poisoned with carbon monoxide in this study in the measured samples shows that the number of samples that did not have CT Scan changes are more (91%). Based on the results of this study, there is a significant difference between the increase in the level of QTcB and QTc F with the chance of observing changes in CT Scan and the average QTc B and the average QTc F. There are no different CT conditions. And in other words, it can be said that the increase of QTc B and QTc F does not change the chance of observing a decrease in the level of consciousness and does not show a significant difference in different levels of consciousness. But the results also showed that QTc B has a significant difference at least in two levels of consciousness (UP and VA), which is more in the UP group. Also, there is a significant correlation between QTc B and level of consciousness according to GCS. According to the findings of the present study, there was no significant relationship between the decrease in level of consciousness (based on AVPU) in patients poisoned with carbon monoxide and the chance of brain CT scan changes. However, CT scan changes were visible only in patients with a severe decrease in level of consciousness. Finally, according to the findings of the present study, there was a significant correlation between the decrease in level of consciousness according to CGS in patients poisoned with carbon monoxide and changes in CT scan of the brain. and GCS showed a significant difference in different groups which was higher in CTNo group.