5PSQ-069 QT-prolonging drugs in high-risk post-surgical patients: are we aware of their risks?
Year: 2025
Type: conference-paper
Abstract: Background and Importance QT interval prolongation (iQT) is associated with life-threatening ventricular arrhythmias, notably Torsades de Pointes (TdP). Medications are the primary cause of QT prolongation, frequently prescribed to hospitalised patients, particularly in the post-surgical setting. Aim and Objectives To evaluate the result of pharmaceutical interventions (PIs) related to the use of QT-prolonging drugs (QTPDs) in post-surgical patients at high-risk of developing arrhythmias. Material and Methods A prospective longitudinal study was conducted over 4 weeks in a tertiary care hospital. Inclusion criteria: post-surgical patients prescribed at least one QTPD during hospitalisation. Variables: number and type of QTPDs, presence of key risk factors (RFs), number and type of PIs, and whether prescribers followed recommendations. Data were collected from the prescription system and Electronic Medical Record, later analysed using Excel. PIs were conducted for patients with two QTPDs or with one QTPD and three or more RFs. QTPDs were identified from the AZCERT database. RFs were selected from the RISQ-PATH scale: female sex, age > 65, and cardiac, thyroid, or electrolyte disturbances (hypokalaemia, hypocalcaemia). Interventions were standardised into four categories: electrocardiographic monitoring, deprescribing or dose reduction, substitution with safer alternatives, and general recommendations (adjusting modifiable RFs and risk-benefit consideration). PIs were communicated through the prescription system and/or phone calls, with a 3-day follow-up to evaluate physician adherence to interventions. Patients not initially intervened were monitored until discharge for potential new RFs. A descriptive statistical analysis was performed, using absolute frequency for categorical variables and geometric mean or median for quantitative variables. Results Sixty-two patients were included (58% female, median of 66.5 years with an interquartile range of 26, mean of 11.9±4 prescribed medications). The most frequently prescribed QTPDs were antibiotics (44.9%), followed by nervous system (27.5%) and digestive system drugs (23.2%). Sixty-five interventions were performed in 28 patients. General recommendations were the most frequent intervention (n=28), followed by electrocardiographic monitoring (n=25), dose reduction (n=8), and therapeutic substitution (n=4). 10.7% of PIs led to prescriber changes. Conclusion and Relevance Only 10.7% of PIs resulted in prescriber changes, reflecting low intervention acceptance. Given that PIs were limited to high-risk patients with clearly defined risks, greater awareness of the safe use of these medications is needed for healthcare professionals. References and/or Acknowledgements Conflict of Interest No conflict of interest
Authors: A Martínez García, C Perez Menendez-Conde, C García-Guijas García, ME Gómez de Salazar López de Silanes, MDR Pintor Recuenco, AM Álvarez Díaz
Institution: Hospital Universitario Ramón y Cajal
Language: English
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408376015