{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T20:13:58Z","timestamp":1773260038388,"version":"3.50.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T00:00:00Z","timestamp":1575590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Methadone is an opioid commonly used for acute pain management in burn patients. One adverse effect of methadone is QTc interval prolongation, which may be associated with adverse cardiac outcomes. There is currently a paucity of data regarding risk of QTc prolongation in burn patients taking methadone and a lack of evidence-based recommendations for monitoring strategies in this population. The study objective was to determine the prevalence, risk factors, and cardiac outcomes related to methadone-associated QTc prolongation in adult burn patients. A total of 91 patients were included and were divided into groups according to maximum QTc. QTc prolongation was defined as greater than or equal to 470 ms (males) or 480 ms (females). There were no differences between groups regarding patient-specific risk factors, baseline QTc, or time to longest QTc. Patients in the prolonged QTc group had a higher rate of cardiac events (44% vs 9%; P &amp;lt; .001), higher median (IQR) change from baseline to longest QTc (61 ms [18,88] vs 23 ms [13,38]; P &amp;lt; .001), higher median (IQR) total daily dose of methadone (90 mg [53,98] vs 53 mg [30,75]; P = .004), and longer median (IQR) length of stay (53 [33,82] vs 35 [26,52] days; P = .008). QTc prolongation in burn patients was associated with increased methadone dose and resulted in a higher rate of cardiac events. This study was the first of its kind to look at risk factors and cardiac outcomes associated with methadone use in burn patients.<\/jats:p>","DOI":"10.1093\/jbcr\/irz200","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T14:33:12Z","timestamp":1575642792000},"page":"416-420","source":"Crossref","is-referenced-by-count":6,"title":["Risk Factors and Prevalence of QTc Prolongation in Adult Burn Patients Receiving Methadone"],"prefix":"10.1093","volume":"41","author":[{"given":"Todd A","family":"Walroth","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Eskenazi Health, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison N","family":"Boyd","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Rhode Island Hospital, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison M","family":"Hester","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Grady Health System, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilyn K","family":"Schoenle","sequence":"first","affiliation":[{"name":"Department of Pharmacy and Therapeutics, University of Pittsburgh Medical Center Presbyterian, Shadyside, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett C","family":"Hartman","sequence":"first","affiliation":[{"name":"Richard M. Fairbanks Burn Center, Eskenazi Health, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajiv","family":"Sood","sequence":"first","affiliation":[{"name":"Richard M. Fairbanks Burn Center, Eskenazi Health, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,12,6]]},"reference":[{"key":"2020021913593644300_CIT0001","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jcrc.2016.03.023","article-title":"Methadone analgesia in the critically ill","volume":"34","author":"Elefritz","year":"2016","journal-title":"J Crit Care"},{"key":"2020021913593644300_CIT0002","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1097\/BCR.0b013e3181eebee9","article-title":"Prevalence and risk factors for development of delirium in burn intensive care unit patients","volume":"31","author":"Agarwal","year":"2010","journal-title":"J Burn Care Res"},{"key":"2020021913593644300_CIT0003","doi-asserted-by":"crossref","first-page":"R49","DOI":"10.1186\/cc11250","article-title":"Replacement of fentanyl infusion by enteral methadone decreases the weaning time from mechanical ventilation: a randomized controlled trial","volume":"16","author":"Wanzuita","year":"2012","journal-title":"Crit Care"},{"key":"2020021913593644300_CIT0004","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/j.jelectrocard.2017.02.001","article-title":"Hypokalemia in women and methadone therapy are the strongest non-cardiologic factors associated with QT prolongation in an emergency department setting","volume":"50","author":"Marill","year":"2017","journal-title":"J Electrocardiol"},{"key":"2020021913593644300_CIT0005","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1089\/jpm.2016.0411","article-title":"Methadone and corrected QT Prolongation in pain and palliative care patients: a case-control study","volume":"20","author":"Juba","year":"2017","journal-title":"J Palliat Med"},{"key":"2020021913593644300_CIT0006","doi-asserted-by":"crossref","first-page":"235","DOI":"10.3109\/00952990.2013.804525","article-title":"QTc interval prolongation for patients in methadone maintenance treatment: a five years follow-up study","volume":"39","author":"Fareed","year":"2013","journal-title":"Am J Drug Alcohol Abuse"},{"key":"2020021913593644300_CIT0007","doi-asserted-by":"crossref","first-page":"501","DOI":"10.7326\/0003-4819-137-6-200209170-00010","article-title":"Torsade de pointes associated with very-high-dose methadone","volume":"137","author":"Krantz","year":"2002","journal-title":"Ann Intern Med"},{"key":"2020021913593644300_CIT0008","volume-title":"Lexi-Drugs. 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[3 Sept 2018], AZCERT, Inc. 1822 Innovation Park Dr., Oro Valley, AZ 85755. Available from http:\/\/www.Crediblemeds.org. Accessed 3 Sept 2018."},{"key":"2020021913593644300_CIT0013","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.jpainsymman.2013.09.021","article-title":"Methadone for pain and the risk of adverse cardiac outcomes","volume":"48","author":"Price","year":"2014","journal-title":"J Pain Symptom Manage"},{"key":"2020021913593644300_CIT0014","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s40291-015-0137-4","article-title":"A Possible mechanistic link between the CYP2C19 genotype, the methadone metabolite ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidene (EDDP), and methadone-induced corrected QT interval prolongation in a pilot study","volume":"19","author":"Carlquist","year":"2015","journal-title":"Mol Diagn Ther"},{"key":"2020021913593644300_CIT0015","first-page":"577","article-title":"A systematic review of the cardiotoxicity of methadone","volume":"14","author":"Alinejad","year":"2015","journal-title":"EXCLI J"},{"key":"2020021913593644300_CIT0016","doi-asserted-by":"crossref","first-page":"338","DOI":"10.4097\/kjae.2010.58.4.338","article-title":"Retrospective analysis of low-dose methadone and QTc prolongation in chronic pain patients","volume":"58","author":"Huh","year":"2010","journal-title":"Korean J Anesthesiol"},{"key":"2020021913593644300_CIT0017","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/1755-5922.12120","article-title":"Methadone therapy in underserved urban community: QTc prolongation and life-threatening ventricular arrhythmias","volume":"33","author":"Chowdhury","year":"2015","journal-title":"Cardiovasc Ther"},{"key":"2020021913593644300_CIT0018","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1002\/phar.2146","article-title":"Predictive analytics for identification of patients at risk for QT interval prolongation: a systematic review","volume":"38","author":"Tomaselli Muensterman","year":"2018","journal-title":"Pharmacotherapy"},{"key":"2020021913593644300_CIT0019","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s12012-018-9474-y","article-title":"Electrocardiographic findings in mortalities due to pure Methadone Toxicity","volume":"19","author":"Sheibani","year":"2019","journal-title":"Cardiovasc Toxicol"},{"key":"2020021913593644300_CIT0020","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/j.1552-4604.1990.tb03441.x","article-title":"Pharmacokinetics of continuous intravenous infusion of methadone in the early post-burn period","volume":"30","author":"Denson","year":"1990","journal-title":"J Clin Pharmacol"},{"key":"2020021913593644300_CIT0021","doi-asserted-by":"crossref","first-page":"e825","DOI":"10.1097\/CCM.0000000000003299","article-title":"Clinical practice guidelines for the prevention and management of pain, Agitation\/Sedation, delirium, immobility, and sleep disruption in adult patients in the ICU","volume":"46","author":"Devlin","year":"2018","journal-title":"Crit Care Med"}],"container-title":["Journal of Burn Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jbcr\/advance-article-pdf\/doi\/10.1093\/jbcr\/irz200\/31675928\/irz200.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jbcr\/article-pdf\/41\/2\/416\/32525106\/irz200.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jbcr\/article-pdf\/41\/2\/416\/32525106\/irz200.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T20:42:25Z","timestamp":1582144945000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbcr\/article\/41\/2\/416\/5663568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,6]]},"references-count":21,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,12,6]]},"published-print":{"date-parts":[[2020,2,19]]}},"URL":"https:\/\/doi.org\/10.1093\/jbcr\/irz200","relation":{},"ISSN":["1559-047X","1559-0488"],"issn-type":[{"value":"1559-047X","type":"print"},{"value":"1559-0488","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,3]]},"published":{"date-parts":[[2019,12,6]]}}}