Abstract：
BACKGROUND: QTc interval prolongation can result in potentially lethal arrhythmias. One risk factor is QTc-prolonging drugs, including some antifungals often used in hemato-oncology patients. Screening tools for patients at risk have not yet been investigated in this patient population.
OBJECTIVE: Our aim was to evaluate the sensitivity and specificity of five QTc risk scores in hemato-oncology patients receiving systemic antifungal therapy.
METHODS: Data were retrieved from an internal study database including adult hemato-oncology patients prescribed systemic antifungal therapy. Data on QTc-prolonging medication, risk factors for QTc prolongation, and electrocardiograms (ECG) were collected retrospectively for a period of 12 months. The QTc risk scores according to Tisdale, Vandael, Berger, Bindraban, and Aboujaoude as well as their sensitivity and specificity were calculated.
RESULTS: During the evaluated period, 77 patients were prescribed systemic antifungals resulting in 187 therapy episodes. Regarding therapy episodes, median age was 56 years (IQR 44-68), 41% (77) were female, and a median of 3 QTc-prolonging drugs were prescribed (range 0-6). ECGs were available for 45 (24%) of the therapy episodes 3-11 days after initiation of the antifungal therapy, 22 of which showed QTc prolongation. Regarding these 45 therapy episodes, sensitivity and specificity of the risk scores were calculated as follows: Tisdale 86%/22%, Vandael 91%/35%, Berger 32%/83%, Bindraban 50%/78%, Aboujaoude 14%/87%.
CONCLUSIONS: The QTc risk scores according to Tisdale and Vandael showed sufficient sensitivity for risk stratification in the studied patient population. In contrast, risk scores according to Berger, Bindraban, and Aboujaoude cannot be considered suitable due to poor sensitivity.
OBJECTIVE: Our aim was to evaluate the sensitivity and specificity of five QTc risk scores in hemato-oncology patients receiving systemic antifungal therapy.
METHODS: Data were retrieved from an internal study database including adult hemato-oncology patients prescribed systemic antifungal therapy. Data on QTc-prolonging medication, risk factors for QTc prolongation, and electrocardiograms (ECG) were collected retrospectively for a period of 12 months. The QTc risk scores according to Tisdale, Vandael, Berger, Bindraban, and Aboujaoude as well as their sensitivity and specificity were calculated.
RESULTS: During the evaluated period, 77 patients were prescribed systemic antifungals resulting in 187 therapy episodes. Regarding therapy episodes, median age was 56 years (IQR 44-68), 41% (77) were female, and a median of 3 QTc-prolonging drugs were prescribed (range 0-6). ECGs were available for 45 (24%) of the therapy episodes 3-11 days after initiation of the antifungal therapy, 22 of which showed QTc prolongation. Regarding these 45 therapy episodes, sensitivity and specificity of the risk scores were calculated as follows: Tisdale 86%/22%, Vandael 91%/35%, Berger 32%/83%, Bindraban 50%/78%, Aboujaoude 14%/87%.
CONCLUSIONS: The QTc risk scores according to Tisdale and Vandael showed sufficient sensitivity for risk stratification in the studied patient population. In contrast, risk scores according to Berger, Bindraban, and Aboujaoude cannot be considered suitable due to poor sensitivity.
摘要：
背景：QTc间期延长可导致潜在致死性心律失常。一个危险因素是延长QTc的药物，包括一些常用于血液肿瘤患者的抗真菌药物。尚未在该患者人群中研究处于危险中的患者的筛查工具。
目的：我们的目的是评估接受全身抗真菌治疗的血液肿瘤患者的五个QTc风险评分的敏感性和特异性。
方法：数据来自内部研究数据库，包括接受全身抗真菌治疗的成人血液肿瘤患者。关于延长QTc药物的数据，QTc延长的危险因素，和心电图(ECG)回顾性收集,为期12个月.根据Tisdale的QTc风险评分，Vandael,伯杰,宾德拉班,并计算Aboujaoude的敏感性和特异性。
结果：在评估期间，77名患者接受了全身性抗真菌药物治疗，导致187次治疗发作。关于治疗发作，中位年龄为56岁(IQR44-68)，41%（77）是女性，处方中的3种QTc延长药物（范围0-6）。开始抗真菌治疗后3-11天，45（24％）的治疗发作可获得心电图，其中22例显示QTc延长。关于这45次治疗发作，风险评分的敏感性和特异性计算如下：Tisdale86%/22%，Vandael91%/35%，伯杰32%/83%，Bindraban50%/78%,Aboujaoude14%/87%。
结论：根据Tisdale和Vandael的QTc风险评分对研究患者人群的风险分层显示出足够的敏感性。相比之下,根据伯杰的风险评分，宾德拉班,而Aboujaoude由于敏感性差不能被认为是合适的。
目的：我们的目的是评估接受全身抗真菌治疗的血液肿瘤患者的五个QTc风险评分的敏感性和特异性。
方法：数据来自内部研究数据库，包括接受全身抗真菌治疗的成人血液肿瘤患者。关于延长QTc药物的数据，QTc延长的危险因素，和心电图(ECG)回顾性收集,为期12个月.根据Tisdale的QTc风险评分，Vandael,伯杰,宾德拉班,并计算Aboujaoude的敏感性和特异性。
结果：在评估期间，77名患者接受了全身性抗真菌药物治疗，导致187次治疗发作。关于治疗发作，中位年龄为56岁(IQR44-68)，41%（77）是女性，处方中的3种QTc延长药物（范围0-6）。开始抗真菌治疗后3-11天，45（24％）的治疗发作可获得心电图，其中22例显示QTc延长。关于这45次治疗发作，风险评分的敏感性和特异性计算如下：Tisdale86%/22%，Vandael91%/35%，伯杰32%/83%，Bindraban50%/78%,Aboujaoude14%/87%。
结论：根据Tisdale和Vandael的QTc风险评分对研究患者人群的风险分层显示出足够的敏感性。相比之下,根据伯杰的风险评分，宾德拉班,而Aboujaoude由于敏感性差不能被认为是合适的。
