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NCT Number: NCT07196891

Predictive Role of f-QRST Angle in Subarachnoid Hemorrhage

The investigators investigated the association between the frontal QRS/T angle measured on admission ECG and 28-day mortality, as well as neurological outcome in patients with non-traumatic aneurysmal SAH. Specifically, the investigators tested the hypothesis that an increased frontal QRS/T angle would be independently associated with higher mortality and poorer clinical outcomes in patients with SAH. Accordingly, the investigators also analyzed the relationship between the frontal QRS/T angle and neurological status assessed based on Glasgow Outcome Scale (GOS), as well as disease severity determined by the Hunt-Hess and Fisher grading systems.

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Key information

Conditions

Subarachnoid Hemorrhage, Aneurysmal Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Hemorrhage Intracranial Hemorrhages Nervous System Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Subarachnoid Hemorrhage Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Haseki Training and Research Hospital

Istanbul, Fatih, 34265, Turkey (Türkiye)

About this study

Patients were divided into two groups: survivors and non-survivors. Survivors were further classified as mobile or immobile according to the Glasgow Outcome Scale (GOS). Patients who remained comatose or dependent in daily activities were classified as immobile (GOS 1-3), while those who returned to normal life or were able to perform daily activities independently were classified as mobile (GOS 4-5). Demographic and clinical characteristics as well as ECG findings were compared between these groups, and the relationship between the frontal QRS/T angle, 28-day mortality, and disease severity was evaluated. Independent predictors of mortality were determined by multivariate logistic regression analysis of variables (demographic characteristics, clinical characteristics, and ECG changes) that differed significantly between survivors and non-survivors. An area under the curve (AUC) analysis was then conducted to identify the predictive role of the f-QRST angle in patients with SAH.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • patients (aged ≥ 18 years) who presented to the emergency department with non-traumatic Subarachnoid Hemorrhage between July 2020 and July 2025

Exclusion criteria

  • patients younger than 18 years
  • patients with missing information
  • patients with traumatic SAH
  • patients with subdural or epidural hemorrhage
  • patients with concurrent ischemic stroke

Treatment and study plan

frontal-QRST angle

Other

The frontal QRS/T angle represents the angle between the ventricular depolarization (QRS) and repolarization (T) vectors on the ECG and serves as a parameter for assessing cardiac electrical heterogeneity. In this study, the frontal QRS/T angle was calculated using data obtained from standard 12-lead surface ECGs. The QRS and T axes in the frontal plane were derived from the automated ECG device reports.

Hunt-Hess scale

Other

The Hunt-Hess scale was used to assess SAH severity according to the clinical presentation and the visible neurological deficits. The Grades run from 1 to 5: - Grade 1: Asymptomatic or minimal headache, slight neck stiffness. - Grade 2: Moderate to severe headache, and neck stiffness, but no neurological deficit except cranial nerve palsy. - Grade 3: Drowsiness, confusion, or a mild focal deficit. - Grade 4: Stupor, moderate to severe hemiparesis, early decerebrate rigidity, and vegetative disturbance. - Grade 5: Deep coma, decerebrate rigidity, and a moribund appearance.

modified Fisher scale

Other

The modified Fisher scale was used to evaluate SAH severity by reference to the extent of hemorrhage as revealed by CT of the brain. Four grades are depending on the degree of bleeding observed: - Grade 0: No hemorrhage apparent in CT. - Grade 1: Minimal hemorrhage without intraventricular hemorrhage (IVH). - Grade 2: Thin or diffusely thin (<1mm) hemorrhage with bilateral IVH. - Grade 3: Thick (> 1 mm) hemorrhage without bilateral IVH. - Grade 4: Thick (> 1 mm) hemorrhage with bilateral IVH.

Primary outcomes

  1. Predictive ability of frontal-QRST angle for 28-day mortality

    Time frame: From admission to 28 days

    The investigators assessed the predictive ability of frontal-QRST angle in determining 28-day mortality.

Secondary outcomes

  1. Predictive ability of frontal-QRST angle for neurological survival

    Time frame: From admission to 28 days

    The investigators assessed the predictive ability of frontal-QRST angle in determining neurological survival

Sponsors and collaborators

Lead sponsor

Haseki Training and Research Hospital

Other

Registry information

Official study title

Prognostic Value of the Frontal QRS/T Angle for 28-day Mortality and Neurological Outcomes in Aneurysmal Subarachnoid Hemorrhage

Acronym: f-QRST in SAH

Important dates

Study start
2020
Primary completion
2025
Study completion
2025
First posted
Sep 29, 2025
Registry last updated
Sep 29, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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