Development of atrial fibrillation following trauma increases short term risk of cardiovascular events. J Osteopath Med 2021 Mar 10;121(6):529-537
Date
03/11/2021Pubmed ID
33691355Pubmed Central ID
PMC8159849DOI
10.1515/jom-2020-0260Scopus ID
2-s2.0-85102554059 (requires institutional sign-in at Scopus site)Abstract
CONTEXT: New onset atrial fibrillation (AF) is associated with poor outcomes in several different patient populations.
OBJECTIVES: To assess the effect of developing AF on cardiovascular events such as myocardial infarction (MI) and cerebrovascular accident (CVA) during the acute index hospitalization for trauma patients.
METHODS: The Healthcare Cost and Utilization Project State Inpatient Databases for California and Florida were used to identify adult trauma patients (18 years of age or older) who were admitted between 2007 and 2010. After excluding patients with a history of AF and prior history of cardiovascular events, patients were evaluated for MI, CVA, and death during the index hospitalization. A secondary analysis was performed using matched propensity scoring based on age, race, and preexisting comorbidities.
RESULTS: During the study period, 1,224,828 trauma patients were admitted. A total of 195,715 patients were excluded for a prior history of AF, MI, or CVA. Of the remaining patients, 15,424 (1.5%) met inclusion criteria and had new onset AF after trauma. There was an associated increase in incidence of MI (2.9 vs. 0.7%; p<0.001), CVA (2.6 vs. 0.4%; p<0.001), and inpatient mortality (8.5 vs. 2.1%; p<0.001) during the index hospitalization in patients who developed new onset AF compared with those who did not. Cox proportional hazards regression demonstrated an increased risk of MI (odds ratio [OR], 2.35 [2.13-2.60]), CVA (OR, 3.90 [3.49-4.35]), and inpatient mortality (OR, 2.83 [2.66-3.00]) for patients with new onset AF after controlling for all other potential risk factors.
CONCLUSIONS: New onset AF in trauma patients was associated with increased incidence of myocardial infarction (MI), cerebral vascular accident (CVA), and mortality during index hospitalization in this study.
Author List
Nassoiy SP, Blackwell RH, Brown M, Kothari AN, Plackett TP, Kuo PC, Posluszny JAAuthor
Anai N. Kothari MD Assistant Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Atrial Fibrillation
Female
Florida
Humans
Male
Medicare
Middle Aged
Myocardial Infarction
Risk Factors
Stroke
United States
