NCT07196891

Predictive Role of f-QRST Angle in Subarachnoid Hemorrhage

Prognostic Value of the Frontal QRS/T Angle for 28-day Mortality and Neurological Outcomes in Aneurysmal Subarachnoid Hemorrhage

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 354 (actual)
• Sponsor: Haseki Training and Research Hospital · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The investigators investigated the association between the frontal QRS/T angle measured on admission ECG and 28-day mortality, as well as neurological outcome in patients with non-traumatic aneurysmal SAH. Specifically, the investigators tested the hypothesis that an increased frontal QRS/T angle would be independently associated with higher mortality and poorer clinical outcomes in patients with SAH. Accordingly, the investigators also analyzed the relationship between the frontal QRS/T angle and neurological status assessed based on Glasgow Outcome Scale (GOS), as well as disease severity determined by the Hunt-Hess and Fisher grading systems.

Detailed description

Patients were divided into two groups: survivors and non-survivors. Survivors were further classified as mobile or immobile according to the Glasgow Outcome Scale (GOS). Patients who remained comatose or dependent in daily activities were classified as immobile (GOS 1-3), while those who returned to normal life or were able to perform daily activities independently were classified as mobile (GOS 4-5). Demographic and clinical characteristics as well as ECG findings were compared between these groups, and the relationship between the frontal QRS/T angle, 28-day mortality, and disease severity was evaluated. Independent predictors of mortality were determined by multivariate logistic regression analysis of variables (demographic characteristics, clinical characteristics, and ECG changes) that differed significantly between survivors and non-survivors. An area under the curve (AUC) analysis was then conducted to identify the predictive role of the f-QRST angle in patients with SAH.

Conditions

• Subarachnoid Hemorrhage, Aneurysmal

Interventions

Type	Name	Description
OTHER	frontal-QRST angle	The frontal QRS/T angle represents the angle between the ventricular depolarization (QRS) and repolarization (T) vectors on the ECG and serves as a parameter for assessing cardiac electrical heterogeneity. In this study, the frontal QRS/T angle was calculated using data obtained from standard 12-lead surface ECGs. The QRS and T axes in the frontal plane were derived from the automated ECG device reports.
OTHER	Hunt-Hess scale	The Hunt-Hess scale was used to assess SAH severity according to the clinical presentation and the visible neurological deficits. The Grades run from 1 to 5: - Grade 1: Asymptomatic or minimal headache, slight neck stiffness. - Grade 2: Moderate to severe headache, and neck stiffness, but no neurological deficit except cranial nerve palsy. - Grade 3: Drowsiness, confusion, or a mild focal deficit. - Grade 4: Stupor, moderate to severe hemiparesis, early decerebrate rigidity, and vegetative disturbance. - Grade 5: Deep coma, decerebrate rigidity, and a moribund appearance.
OTHER	modified Fisher scale	The modified Fisher scale was used to evaluate SAH severity by reference to the extent of hemorrhage as revealed by CT of the brain. Four grades are depending on the degree of bleeding observed: - Grade 0: No hemorrhage apparent in CT. - Grade 1: Minimal hemorrhage without intraventricular hemorrhage (IVH). - Grade 2: Thin or diffusely thin (\<1mm) hemorrhage with bilateral IVH. - Grade 3: Thick (\> 1 mm) hemorrhage without bilateral IVH. - Grade 4: Thick (\> 1 mm) hemorrhage with bilateral IVH.

Timeline

• Start date: 2020-07-01
• Primary completion: 2025-07-01
• Completion: 2025-09-01
• First posted: 2025-09-29
• Last updated: 2025-09-29

Locations

1 site across 1 country: Turkey (Türkiye)