Tisdale_risk_score_for_QT_prolongation v.1
Prediction on risk of QT prolongation in hospitalized patients.
To predict the risk of QT prolongation greater than 500 msec in hospitalized patients.
This simple score can estimate risk of QT prolongation for a physician or pharmacist managing a patient in the hospital. Why use QT interval prolongation increases the risk of Torsade de pointes (TdP), a type of polymorphic ventricular tachycardia which is life-threatening and often fatal.
There are many known factors that increase the risk of QT prolongation; the ones included in this score were found to be the most predictive, but others should not be ignored. Some of the other common risks include: Other electrolyte abnormalities like hypomagnesemia or hypocalcemia Inadequate dose adjustment for patients with acute or chronic kidney dysfunction Drug-drug interactions CredibleMeds.org provides an outstanding comprehensive list of clinical risk factors for QT prolongation. CredibleMeds.org also provides a comprehensive list of drugs that may cause QT prolongation. Drug-drug interactions should always be considered when prescribing multiple medications; this score does not include pharmacokinetic drug interactions. This score also does not consider dosing adjustments for renally-eliminated drugs. Clinicians should always try to avoid QT-prolonging medications when possible. Maintaining normal electrolyte levels can help reduce the risk of QT prolongation as well. Patients with very poor ejection fractions (<20%) are particularly high risk for QT prolongation.
References: 1. Tisdale JE, Jaynes HA, Kingery JR, et al. Development and validation of a risk score to predict QT interval prolongation in hospitalized patients. Circ Cardiovasc Qual Outcomes. 2013;6(4):479-87. 2. Tisdale JE, Jaynes HA, Kingery JR, Overholser BR, Mourad NA, Trujillo TN, Kovacs RJ. Effectiveness of a clinical decision support system for reducing the risk of QT interval prolongation in hospitalized patients. Circ Cardiovasc Qual Outcomes 2014;7:381-390. 3.Tisdale JE. Drug-induced QT interval prolongation and torsades de pointes: Role of the pharmacist in risk assessment, prevention and management. Can Pharm J (Ott). 2016;149(3):139-52.
openEHR-EHR-OBSERVATION.tisdale_risk_score_for_qt_prolongation, openEHR-EHR-EVALUATION.tisdale_risk_score_for_qt_prolongation
