Association between Prolonged QRS Duration (>110 milliseconds) and In-hospital Outcomes of Patients with Heart Failure: Data from the Medical Registry of a Tertiary Hospital in Bangladesh

Open Access

Abstract

Background: Heart failure is a major cause of morbidity and mortality worldwide. Electrocardiographic parameters, particularly QRS duration, may provide important prognostic information in patients with heart failure. This study aimed to evaluate the relationship between QRS duration on admission ECG and in-hospital outcomes among patients admitted with heart failure. Methods & Materials: This retrospective observational study was conducted in the Department of Cardiology at Dhaka Medical College Hospital, Dhaka, from 01 January to 31 December 2025. A total of 100 adult patients admitted with a primary diagnosis of heart failure were included. Results: The mean age of the study population was 59.27 ± 11.63 years and 67% were male. Sinus rhythm was observed in 93% of patients. Hypertension and diabetes mellitus were present in 50% and 54% of patients respectively, while ischemic heart disease was highly prevalent (88%). Patients with prolonged QRS duration (>110 ms) had higher rates of in-hospital mortality (10.00% vs 4.00%), cardiogenic shock (36.00% vs 18.00%), requirement of intravenous inotropic/vasopressors support (36.00% vs 18.00%) and need for mechanical ventilation (12.00% vs 4.00%) and p = 0.269 compared with those with normal QRS duration (≤110 ms). The mean hospital stay was also longer in the prolonged QRS group (10.66 ± 6.647 vs 7.52 ± 5.686 days; p = 0.013). Conclusion: Prolonged QRS duration on admission ECG is associated with poorer in-hospital outcomes among patients with heart failure. QRS duration may serve as a simple and useful marker for early risk stratification in hospitalized heart failure patients.