Title: Correlation of QTc Interval and Outcomes After Methadone Overdose<br/>Author: Bryan Hayes<br/><a href='http://umem.org/profiles/faculty/369/'>[Click to email author]</a><hr/><p>
Methadone prolongs the QTc interval. Is the degree of QTC widening correlated to worse outcomes after overdose?</p>
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A new study demonstrated <span style="color: rgb(0, 0, 0); font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 17.999801635742188px;">the ability of triage QTc to predict </span><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 17.999801635742188px;">death, </span><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 17.999801635742188px;">intubation, and </span><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 17.999801635742188px;">respiratory arrest showed thresholds of 470, 447.5, and 450 ms with sensitivity (95 % CI) and specificity (95 % CI) of 87.5 (47.3-99.7), 86.8 (74.7-94.5), and 77.3 (62.2-88.5), respectively.</span></p>
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<span style="color: rgb(0, 0, 0); font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 17.999801635742188px;"><u>Application to clinical practice</u>: QTc interval prolongation has the potential to help predict outcomes after methadone overdose, but the QTc thresholds in this study were really not that prolonged. Patients on chronic methadone <u>without</u> overdose have baseline QTc intervals longer than those in the study <u>after</u> overdose. Many factors contribute to the ultimate disposition of methadone overdose cases.</span></p>
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Farsi D, et al. The correlation between prolonged corrected QTc interval with the frequency of respiratory arrest, endotracheal intubation, and mortality in acute methadone overdose. <em>Cardiovasc Toxicol</em> 2014 May 9. [Epub ahead of print] [<a href="http://www.ncbi.nlm.nih.gov/pubmed/24811951">PMID 24811951</a>]</p>
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