The relationship between QT interval and pain severity in trauma patients in the emergency department

Abstract

Aim: Cardiac depolarization occurs in patients experiencing pain from acute traumas, and changes in QT interval could indicate the state of ventricular depolarization. Thus, we aimed to determine the relationship between pain severity and QT interval in patients experiencing acute trauma. Material and Method: Seventy patients, who were conscutively- admitted to the Emergency Department due to moderate or severe trauma (study group), and sixty healthy individuals (control group) were included in this study. The QT interval was calculated for each group before and after analgesia and visual analog scale pain levels were recorded. Statistical analyses were performed using SPSS for Windows software (ver. 21.0; SPSS Inc., Chicago, IL, USA). Data are presented as medians±interquartile range (IQR). Statistical significance was determined using Mann-Whitney U, Wilcoxon, and chi-square tests, with a p-value <0.05 considered significant. Results: The mean age of patients with trauma and control patients was 31.50±25 years and 35.00±20 years, respectively. Among trauma patients, QT, RR and corrected QT (QTc) intervals were significantly different before and after analgesia (P<0.001). Similarly, the average pre-analgesia QT, RR and QTc values also differed between pre- and post-analgesia trauma patients (p=0.007, p<0.001, and p<0.001, respectively). However, no differences in QT values were observed before and after analgesia between patients experiencing moderate versus severe pain (p>0.05). Conclusion: In trauma patients, acute pain prolonged the QT interval, which reverted to normal following the administration of nonsteroidal anti-inflammatory drugs. However, additional comparative studies on this topic are required.