Abstract 16312: Atrial Fibrillation in the Trauma Patient - Rhythm Control May be Lifesaving - A Review of 3.6 Million Cases in the United States National Trauma DataBank
Introduction: There is limited data on the outcomes of trauma in patients with atrial fibrillation. Our study aimed to describe the outcomes and interventions that improve survival of patients with atrial fibrillation that suffered a chest trauma (CT) and or a traumatic brain injury (TBI) in the National Trauma Databank (NTDB)
Methods: We identified patients with ICD 9 codes for atrial fibrillation in the NTDB from 2008 to 2012 who suffered any TBI or CT based on the Barell Injury classification matrix . We also identified ICD 9 procedure codes for the common rhythm control modalities (cardioversion and catheter ablation). We described the patient demographics and performed a logistic regression analysis with mortality, hospital length of stay and ventilator days as outcomes of interest.
Results: We identified 14923 patients in the NTDB who had a diagnosis of atrial fibrillation and 4676 of them had a TBI and or Chest trauma. 45.3 % of the patients were females and the mean age of the TBI/CT cohort was 58.4 ± 11.7yrs. The mean injury severity score (ISS) of the cohort was 17.2 ± 10 while the mean admission Glasgow Coma score was 12.5 ± 4.4. A total of 101 patients underwent a rhythm control procedure while 63 patients underwent a pacemaker placement. Adjusted logistic regression showed that while Rhythm control procedures significantly predicted a longer ventilator days (β= 2.8, t(4669) = 2.0, p < .029), there was a reduced odds for mortality among those who underwent a rhythm control procedure (OR 0.45, p=0.039).
Conclusions: There is a mortality benefit for rhythm control procedures in trauma patients who suffer a TBI and or a CT. while the patients had a moderate to high injury severity scores, they seemed to have a better admission GCS. Further studies are needed to elucidate the patients who will benefit the most from the rhythm control procedures and if early intervention provides even more benefit.
Author Disclosures: O. Olorunfemi: None. G. Ogunbayo: None. O. Ola: None. O. Akinboro: None. R. Melduni: None.
- © 2016 by American Heart Association, Inc.