ECG changes in patients with acute ethanol intoxication

Figures & data

Figure 1.  Flow chart of patient selection in the study

Table I.  Sample descriptive statistics at admission for patients admitted for acute ethanol intoxication and hospitalized controls, mean (SD) unless stated otherwise.

	Ethanol intoxication			Controls
Time for ECG recording	Admission only (n = 52)	Admission and discharge (n = 32)	P	Admission and discharge (n = 27)	p^a
Age (years)	38 (16)	39 (16)	0.90	53 (20)	0.004
Male sex, number (%)	34 (65)	18 (56)	0.40	16 (59)	0.82
S-osmolality (mOsm/kg H2O)	362 (24)	367 (27)	0.40
Comorbidity, number (%)	16 (36)^1	11 (37)^2	0.92	17 (63)	0.03
Heart disease	10 (22)	5 (16)	0.68	6 (22)	0.52
Mixed intoxications, number (%)	14 (27)	15 (47)	0.06
Benzodiazepines	6 (12)	8 (25)
Codein and acetaminophen	6 (12)	4 (13)
Acetaminophen	2 (4)	1 (3)
Neuroleptics	6 (12)	5 (16)
Regular medication, number (%)			0.83
0	27 (63)^3	21 (70)^2		17 (63)
1	6 (14)	3 (12)		3 (11)
≥ 2	10 (23)	8 (27)		7 (26)
Heart rate, min^−1	83.2 (14.9)	88.4 (15.9)	0.13	77.6 (17.6)	0.02
S-Sodium	144.2 (3.2)	143.3 (3.2)	0.25	139.4 (3.3)	<0.001
S-Potassium	4.2 (0.4)	4.0 (0.4)	0.03	3.9(0.4)	0.60

¹n = 45, ²n = 30, ³n = 43. ^aControl group vs. ethanol intoxication with ECG recorded at admission and discharge (n = 32) (column 2)

Table II.  ECG variables at admission according to serum osmolality as a proxy for ethanol level in combined sample of ethanol intoxicated and control group, adjusted marginal mean values (SE), adjusted for age, comorbidity, serum sodium and heart rate.

	High (≥358^a)	Moderate (<358^a)	Control (no ethanol)	P^b
S-osmolality^a, mean (SD)	384.5^c (18.5) n = 43	343.6^c (9.7) n = 41	Normal n = 27	High vs. moderate	Moderate vs. control	High vs. control
P wave, ms	105.7 (2.2)^1	101.1 (2.1)^2	95.0 (2.8)	0.41	0.27	0.02
PR interval, ms	166.4 (4.4)^3	160.4 (4.3)^4	168.1 (5.9)^5	0.99	0.92	1.00
QRS duration, ms	94.5 (1.9)^3	93.3 (1.8)^4	96.5 (2.4)	1.00	0.89	1.00
QTc interval, ms^d	442.9 (3.8)	437.9 (3.8)^6	398.7 (4.9)	1.00	<0.001	<0.001
QT, ms ^e	378.9 (4.8)	373.8 (5.1)	376.9 (6.1)	0.46	0.69	0.79
Heart rate, min^−1 e	84.8 (2.3)	85.5 (2.5)	77.6 (3.4)	0.83	0.06	0.07

¹n = 36 ²n = 35 ³n = 38 ⁴n = 37 ⁵n = 25 ⁶n = 40. ^aS-osmolality in mOsm/kg H₂O. ^bAfter Bonferroni adjustments for multiple comparisons. ^cEstimated serum ethanol concentrations: S-osmolality 384.5 0.32%. S-osmolality 343.6 0.17%. ^aAdjusted only for age, comorbidity and s-sodium in the analysis. ^eNot adjusted in the analysis

Table III.  Change in ECG between admission and discharge, mean (SD)

	Ethanol intoxication (n = 32)		Controls (n = 27)
	Δ^a	p	Δ^a	p
P wave, ms	−9.8 (14.5)	0.001	−0.4 (5.7)	0.74
PR interval, ms	−13.6 (23.3)	0.002	−0.84 (9.4)^1	0.66
QRS duration, ms	−3.5 (7.4)	0.010	1.0 (7.4)	0.47
QTc interval, ms	−33.5 (25.9)^2	<0.001	10.7 (27.8)^3	0.07
QT interval, ms^b	−9.3 (36.0)^2	0.16	−0.8 (23.6)	1.00
Heart rate, min^−1	−3.9 (18.3)	0.23	−2.6 (13.9)	0.33

¹n = 25 ²n = 31, ³n = 24. ^aΔ = value at discharge–value at admission.