Prevalence and Course of Atrial Fibrillation in Critically Ill Trauma Patients

Jeremiah J. Duby, Shannon J. Heintz, Sarah A. Bajorek, Brett H. Heintz, Blythe P. Durbin-Johnson, Christine S Cocanour

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Atrial fibrillation (AF) is the most common cardiac dysrhythmia. Its prevalence, risk factors, course, and complications are not well described in critically ill trauma patients. This was a retrospective, single-center, cohort study at an academic, level 1 trauma center. Trauma patients ≥18 years, identified from the trauma registry and admitted to the intensive care unit (ICU), were sequentially screened for AF. A matched cohort was created by selecting patients consecutively admitted before and after the patients who experienced AF. Of 2591 patients screened, 191 experienced AF, resulting in a prevalence of 7.4%. There was no difference in injury severity score (ISS) between those with and without AF, but patients with AF had higher observed mortality (15.5% vs 6.7%, P <.001). Patients with a history of AF (n = 75) differed from new-onset AF (n = 106) in their mean age, 78.9 ± 8.4 versus 69.2 ± 17.9 years; mean time to AF onset, 1.1 ± 2.3 versus 5.2 ± 10.2 days; median duration of AF, 29.8 (1-745.2) versus 5.9 (0-757) hours; and rate of AF resolution, 28% versus 82.1%, respectively. Despite a higher ISS, Sequential Organ Failure Assessment and length of stay, the new-onset AF group experienced a similar rate of mortality compared to the history of AF group (14.7% vs 16.0%). Patients with AF had a higher mortality when compared to those in sinus rhythm. The course of AF in the new-onset AF group occurred later was shorter and was more likely to convert; however, these patients had a longer ICU stay when compared to those who had a history of AF.

Original languageEnglish (US)
Pages (from-to)140-145
Number of pages6
JournalJournal of Intensive Care Medicine
Volume32
Issue number2
DOIs
StatePublished - 2017

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Critical Illness
Atrial Fibrillation
Wounds and Injuries
Injury Severity Score
Intensive Care Units
Mortality
Trauma Centers
Registries
Cardiac Arrhythmias
Length of Stay

Keywords

  • atrial fibrillation
  • critical care
  • mortality

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Prevalence and Course of Atrial Fibrillation in Critically Ill Trauma Patients. / Duby, Jeremiah J.; Heintz, Shannon J.; Bajorek, Sarah A.; Heintz, Brett H.; Durbin-Johnson, Blythe P.; Cocanour, Christine S.

In: Journal of Intensive Care Medicine, Vol. 32, No. 2, 2017, p. 140-145.

Research output: Contribution to journalReview article

Duby, Jeremiah J. ; Heintz, Shannon J. ; Bajorek, Sarah A. ; Heintz, Brett H. ; Durbin-Johnson, Blythe P. ; Cocanour, Christine S. / Prevalence and Course of Atrial Fibrillation in Critically Ill Trauma Patients. In: Journal of Intensive Care Medicine. 2017 ; Vol. 32, No. 2. pp. 140-145.
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abstract = "Atrial fibrillation (AF) is the most common cardiac dysrhythmia. Its prevalence, risk factors, course, and complications are not well described in critically ill trauma patients. This was a retrospective, single-center, cohort study at an academic, level 1 trauma center. Trauma patients ≥18 years, identified from the trauma registry and admitted to the intensive care unit (ICU), were sequentially screened for AF. A matched cohort was created by selecting patients consecutively admitted before and after the patients who experienced AF. Of 2591 patients screened, 191 experienced AF, resulting in a prevalence of 7.4{\%}. There was no difference in injury severity score (ISS) between those with and without AF, but patients with AF had higher observed mortality (15.5{\%} vs 6.7{\%}, P <.001). Patients with a history of AF (n = 75) differed from new-onset AF (n = 106) in their mean age, 78.9 ± 8.4 versus 69.2 ± 17.9 years; mean time to AF onset, 1.1 ± 2.3 versus 5.2 ± 10.2 days; median duration of AF, 29.8 (1-745.2) versus 5.9 (0-757) hours; and rate of AF resolution, 28{\%} versus 82.1{\%}, respectively. Despite a higher ISS, Sequential Organ Failure Assessment and length of stay, the new-onset AF group experienced a similar rate of mortality compared to the history of AF group (14.7{\%} vs 16.0{\%}). Patients with AF had a higher mortality when compared to those in sinus rhythm. The course of AF in the new-onset AF group occurred later was shorter and was more likely to convert; however, these patients had a longer ICU stay when compared to those who had a history of AF.",
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