Clinical and echocardiographic predictors of new‐onset atrial fibrillation in patients admitted with blunt trauma

Background Atrial fibrillation (AF) is a common arrhythmia after trauma or burn injury; however, its predisposing factors are not well known. Moreover, little is known about its effect on mortality and other short‐term clinical outcomes. Objectives This study is aimed at identifying risk factors for...

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Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2018-10, Vol.35 (10), p.1519-1524
Main Authors: Morsy, Mohamed, Slomka, Teresa, Shukla, Anuj, Uppal, Dipan, Bomb, Ritin, Akinseye, Oluwaseun A., Koshy, Santhosh K. G., Garg, Nadish
Format: Article
Language:English
Subjects:
atrial fibrillation
Atrial Fibrillation - complications
Atrial Fibrillation - diagnosis
blunt thoracic trauma
Case-Control Studies
Cohort Studies
echocardiography
Echocardiography - methods
Female
Humans
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Factors
Wounds, Nonpenetrating - complications
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Summary:Background Atrial fibrillation (AF) is a common arrhythmia after trauma or burn injury; however, its predisposing factors are not well known. Moreover, little is known about its effect on mortality and other short‐term clinical outcomes. Objectives This study is aimed at identifying risk factors for new‐onset AF in patients admitted with blunt trauma or burn injuries at a Level 1 academic trauma center, and to determine its effects on the short‐term clinical outcomes. Methods This case–control study compared patients with new‐onset AF with a cohort of patients without AF during the hospital stay after trauma or burn injury. Patients with prior AF or lack of transthoracic echocardiogram were excluded. Demographic, clinical factors including injury severity score and echocardiographic parameters were compared in both cohorts. Risks of short‐term clinical outcomes, namely persistent AF, new stroke, myocardial infarction, or death, were compared. Results Older age, sepsis, CHADS2‐VASC score >1, larger left atrium (LA) size, left ventricular hypertrophy (LVH), and left ventricular diastolic dysfunction imposed a significant risk for new‐onset AF on univariate analysis. On multivariate, independent predictors of new‐onset AF were LA dilation and LVH. LA enlargement increased odds of new‐onset AF by 23‐fold (OR 23; CI: 5.7–92, P 
ISSN:0742-2822
1540-8175
DOI:10.1111/echo.14090