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Clinical and echocardiographic predictors of new‐onset atrial fibrillation in patients admitted with blunt trauma
Author(s) -
Morsy Mohamed,
Slomka Teresa,
Shukla Anuj,
Uppal Dipan,
Bomb Ritin,
Akinseye Oluwaseun A.,
Koshy Santhosh K. G.,
Garg Nadish
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14090
Subject(s) - medicine , cardiology , atrial fibrillation , left ventricular hypertrophy , left atrial enlargement , transthoracic echocardiogram , univariate analysis , odds ratio , stroke (engine) , cohort , blunt trauma , trauma center , multivariate analysis , retrospective cohort study , surgery , sinus rhythm , blood pressure , mechanical engineering , engineering
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, CHADS 2‐ 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 < 0.0001) and the presence of LVH increased the odds of new‐onset AF more than 20‐fold ( OR 20.8; CI : 5–87, P < 0.0001). Conclusions Dilated LA and LVH are independent predictors of new‐onset AF in the patients with blunt trauma or burn. New‐onset AF did not confer increased risk for in‐hospital mortality.