{"pk":50775,"title":"Association of Electrocardiogram Abnormalities with Clinical Outcomes in Emergency Department Sepsis Patients","subtitle":null,"abstract":"<p><strong>Introduction:</strong> Sepsis, a critical condition caused by dysregulated host responses to infection, frequently involves cardiac complications. Electrocardiogram (ECG) provides valuable insights into the cardiovascular status of sepsis patients and may guide early interventions. However, comprehensive data on ECG patterns in sepsis patients within the emergency department (ED) is limited. In this study we aimed to identify common ECG rhythms and patterns in sepsis patients presenting to the ED and analyze their association with poor clinical outcomes, including intensive care unit (ICU) admission, prolonged hospital stay (&gt; 14 days), and in-hospital mortality.</p>\n<p><strong>Methods:</strong> We conducted a retrospective observational study using data from 3,598 adult sepsis patients presenting to the ED of Srinagarind Hospital, Khon Kaen, Thailand, between January–December 2023. ECG abnormalities were extracted from the automated ECG interpretation system. Cardiologists reviewed only ECGs flagged as potential acute infarction or ST elevation to confirm acute coronary syndrome patterns. We analyzed associations between ECG abnormalities and clinical outcomes using univariate logistic regression models.</p>\n<p><strong>Results: </strong>Common ECG rhythms in sepsis patients included sinus rhythm (41.7%), sinus tachycardia (39.0%), and atrial fibrillation/flutter (8.8%). The automated algorithm identified prolonged QT intervals (54.4%) and ST elevation in 10.4% of patients; however, only 1.7% met cardiologist-confirmed criteria for acute coronary syndrome. Compared with patients with better outcomes, those with poor outcomes more frequently had atrial fibrillation/flutter (14.9 vs. 7.5%), new-onset atrial fibrillation/flutter (6.0 vs. 2.8%), QT prolongation (61.6 vs. 52.9%), and abnormal T waves (10.9 vs. 8.4%), corresponding to odds ratios of 2.19 (95% CI, 1.77-2.69), 2.24 (1.50-3.28), 1.43 (1.20-1.70), and 1.34 (1.01-1.76), respectively.</p>\n<p><strong>Conclusion: </strong>Certain ECG abnormalities in sepsis patients are associated with adverse clinical outcomes. Incorporating ECG assessments into sepsis protocols may enhance the early identification of high-risk patients and improve management strategies in the ED.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Septic cardiomyopathy"},{"word":"atrial fibrillation"},{"word":"QT interval prolongation"},{"word":"risk stratification"},{"word":"Emergency electrocardiography"},{"word":"Critical illness outcomes"},{"word":"Thailand"}],"section":"Cardiology","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9fx704wf","frozenauthors":[{"first_name":"Praew","middle_name":"","last_name":"Kotruchin","name_suffix":"","institution":"Khon Kaen University, Faculty of Medicine, Department of Emergency Medicine,  Khon Kaen, Thailand","department":""},{"first_name":"Mingkamon","middle_name":"","last_name":"Chuehongthong","name_suffix":"","institution":"Khon Kaen University, Faculty of Medicine, Department of Emergency Medicine,  Khon Kaen, Thailand","department":""},{"first_name":"Thanat","middle_name":"","last_name":"Tangpaisarn","name_suffix":"","institution":"Khon Kaen University, Faculty of Medicine, Department of Emergency Medicine,  Khon Kaen, Thailand","department":""},{"first_name":"Nattapat","middle_name":"","last_name":"Serewiwattana","name_suffix":"","institution":"Khon Kaen University, Faculty of Medicine, Queen Sirikit Heart Center of the  Northeast, Khon Kaen, Thailand","department":""},{"first_name":"Pariwat","middle_name":"","last_name":"Phungoen","name_suffix":"","institution":"Khon Kaen University, Faculty of Medicine, Department of Emergency Medicine,  Khon Kaen, Thailand","department":""},{"first_name":"Thapanawong","middle_name":"","last_name":"Mitsungnern","name_suffix":"","institution":"Khon Kaen University, Faculty of Medicine, Department of Emergency Medicine,  Khon Kaen, Thailand","department":""},{"first_name":"Marturod","middle_name":"","last_name":"Buranasakda","name_suffix":"","institution":"Khon Kaen University, Faculty of Medicine, Department of Emergency Medicine,  Khon Kaen, Thailand","department":""}],"date_submitted":"2025-08-28T12:56:22.987000Z","date_accepted":"2025-12-05T17:47:30.703000Z","date_published":"2026-02-11T15:34:00Z","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/50775/galley/49064/download/"}]}