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

Mohamed Morsy, Teresa Slomka, Anuj Shukla, Dipan Uppal, Ritin Bomb, Oluwaseun A. Akinseye, Santhosh Koshy, Nadish Garg

Research output: Contribution to journalArticle

Abstract

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 < 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.

Original languageEnglish (US)
Pages (from-to)1519-1524
Number of pages6
JournalEchocardiography
Volume35
Issue number10
DOIs
StatePublished - Oct 1 2018

Fingerprint

Atrial Fibrillation
Wounds and Injuries
Left Ventricular Hypertrophy
Heart Atria
Injury Severity Score
Trauma Centers
Left Ventricular Dysfunction
Hospital Mortality
Causality
Cardiac Arrhythmias
Dilatation
Length of Stay
Sepsis
Stroke
Myocardial Infarction
Demography
Mortality

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Morsy, M., Slomka, T., Shukla, A., Uppal, D., Bomb, R., Akinseye, O. A., ... Garg, N. (2018). Clinical and echocardiographic predictors of new-onset atrial fibrillation in patients admitted with blunt trauma. Echocardiography, 35(10), 1519-1524. https://doi.org/10.1111/echo.14090

Clinical and echocardiographic predictors of new-onset atrial fibrillation in patients admitted with blunt trauma. / Morsy, Mohamed; Slomka, Teresa; Shukla, Anuj; Uppal, Dipan; Bomb, Ritin; Akinseye, Oluwaseun A.; Koshy, Santhosh; Garg, Nadish.

In: Echocardiography, Vol. 35, No. 10, 01.10.2018, p. 1519-1524.

Research output: Contribution to journalArticle

Morsy, M, Slomka, T, Shukla, A, Uppal, D, Bomb, R, Akinseye, OA, Koshy, S & Garg, N 2018, 'Clinical and echocardiographic predictors of new-onset atrial fibrillation in patients admitted with blunt trauma', Echocardiography, vol. 35, no. 10, pp. 1519-1524. https://doi.org/10.1111/echo.14090
Morsy, Mohamed ; Slomka, Teresa ; Shukla, Anuj ; Uppal, Dipan ; Bomb, Ritin ; Akinseye, Oluwaseun A. ; Koshy, Santhosh ; Garg, Nadish. / Clinical and echocardiographic predictors of new-onset atrial fibrillation in patients admitted with blunt trauma. In: Echocardiography. 2018 ; Vol. 35, No. 10. pp. 1519-1524.
@article{d92b8b1364414d4190f2411a2488fe51,
title = "Clinical and echocardiographic predictors of new-onset atrial fibrillation in patients admitted with blunt trauma",
abstract = "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 < 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.",
author = "Mohamed Morsy and Teresa Slomka and Anuj Shukla and Dipan Uppal and Ritin Bomb and Akinseye, {Oluwaseun A.} and Santhosh Koshy and Nadish Garg",
year = "2018",
month = "10",
day = "1",
doi = "10.1111/echo.14090",
language = "English (US)",
volume = "35",
pages = "1519--1524",
journal = "Echocardiography",
issn = "0742-2822",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Clinical and echocardiographic predictors of new-onset atrial fibrillation in patients admitted with blunt trauma

AU - Morsy, Mohamed

AU - Slomka, Teresa

AU - Shukla, Anuj

AU - Uppal, Dipan

AU - Bomb, Ritin

AU - Akinseye, Oluwaseun A.

AU - Koshy, Santhosh

AU - Garg, Nadish

PY - 2018/10/1

Y1 - 2018/10/1

N2 - 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 < 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.

AB - 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 < 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.

UR - http://www.scopus.com/inward/record.url?scp=85050380481&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85050380481&partnerID=8YFLogxK

U2 - 10.1111/echo.14090

DO - 10.1111/echo.14090

M3 - Article

VL - 35

SP - 1519

EP - 1524

JO - Echocardiography

JF - Echocardiography

SN - 0742-2822

IS - 10

ER -