title: Incidence, risk factors, and outcomes for atrial arrhythmias in trauma patients.
abstract: The purpose of this study is to determine the incidence, risk factors, and outcomes after the development of an atrial arrhythmia (AA) in trauma patients admitted to the intensive care unit (ICU). We performed a retrospective study of more than 7 years of trauma patients admitted to the ICU at an urban, academic Level I trauma center. Patients with AA, defined as atrial fibrillation, atrial flutter, or paroxysmal supraventricular tachycardia, were compared with patients without AA. Groups were compared by univariate and multivariate analysis. Three thousand, four hundred and ninety-nine trauma patients were admitted to the ICU during the study period and 210 (6%) developed an AA. AA patients were more likely to sustain blunt trauma, were older, more often female, more severely injured, and sustained more head injuries. The only independent risk factor for developing an AA was age > 55 years (odds ratio = 4.6, P < 0.01). Mortality was higher in the AA group (33% vs. 14%, P < 0.01) and AA was an independent risk factor for mortality (odds ratio = 1.7, P = 0.01). Twenty-eight per cent (n = 59) of AA patients received beta-blockers in the postinjury period, and these patients had lower mortality (22% vs. 37%, P = 0.04). AA occurs in 6 per cent of trauma patients admitted to the ICU. Developing an AA is an independent risk factor for mortality after trauma. Beta-blocker therapy was associated with decreased mortality in trauma patients with AA.
authors.affiliation: Division of Trauma, University of Arizona, Tucson, Arizona 85724-5063, USA.
authors.forename: Pantelis
authors.initials: P
authors.lastname: Hadjizacharia
authors.forename: Terence
authors.initials: T
authors.lastname: O'Keeffe
authors.forename: Carlos V R
authors.initials: CV
authors.lastname: Brown
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
authors.forename: Linda S
authors.initials: LS
authors.lastname: Chan
authors.forename: Demetrios
authors.initials: D
authors.lastname: Demetriades
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D001282:Atrial Flutter / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists