The correlation between ventricular repolarization and clinical severity of spinal cord injuries

Background: Alteration in ventricular repolarization has been reported in patients with spinal cord injuries (SCIs). However, its clinical impact remains unclear. Objective: The purpose of this study was to investigate the correlation between SCIs and ventricular repolarization and the associated clinical impact. Methods: One hundred forty-four patients with an SCI were retrospectively reviewed and were divided into two groups (SCI level ≤T6, n = 110; SCI level >T6, n = 34). The electrocardiograms were reviewed during acute phase (at emergency room) and chronic phase (>1 year). Results: There were no differences in the underlying diseases or in ASIA score between the two groups, except there were more patients with tetraplegia among those with an SCI level ≤T6. For the electrophysiological parameters from the electrocardiograms, the patients with an SCI level ≤T6 had longer QTc and PR interval than those with an SCI level >T6 during acute phase. In the chronic phase, there were no differences in the electrophysiological parameters between the two groups. Only in patients with an SCI level ≤T6 did a Kaplan-Meier analysis show that QTc prolongation could predict 30-day mortality after the acute injury. After multivariate Cox regression analysis, only tetraplegia and QTc prolongation were independent predictors of 30-day mortality (odds ratios 7.85 and 34.62, respectively). In patients with an SCI level ≤T6, the QTc intervals were shorter in the chronic phase than those during the acute phase. Conclusion: QTc interval was associated with the level of acute SCI and predicted the 30-day mortality.