Kanishk Agnihotri1, N V Pothineni2, Paris Charilaou1, Vaibhav R Vaidya3, Badal Thakkar4, Vishal Goyal5, Sabeeda Kadavath6, Nileshkumar Patel5, Apurva Badheka7, Peter Noseworthy3, Suraj Kapa3, Paul Friedman3, Bernard Gersh3, Hakan Paydak2, Abhishek Deshmukh8. 1. Saint Peters University Hospital, New Brunswick, NJ, United States. 2. University of Arkansas Medical Sciences, Little Rock, AR, United States. 3. Mayo Clinic Division of Cardiovascular Diseases, Rochester, MN, United States. 4. Rutgers New Jersey Medical School, Newark, NJ, United States. 5. University of Miami Miller School of Medicine, Miami, FL, United States. 6. Lincoln Medical and Mental Health Center, Bronx, NY, United States. 7. Everett Clinic, Everett, WA, United States. 8. Mayo Clinic Division of Cardiovascular Diseases, Rochester, MN, United States. Electronic address: deshmukh.abhishek@mayo.edu.
Abstract
BACKGROUND: We examined the effect of AF a commonly encountered arrhythmia with significant morbidity on mortality following a motor vehicle accident (MVA) related hospitalization. METHODS: The Nationwide Inpatient Sample (NIS) was queried to identify patients with AF (ICD-9 CM 427.31) and MVA (ICD-9 CM E810.0-E819.9), considered separately and together, from 2003 through 2012. Baseline characteristics were identified and multilevel mixed model multivariate analysis was employed to verify the impact of AF on in-patient mortality in survivors. RESULTS: Of an estimated 2,978,630 MVA admissions reported, 79,687 (2.6%) hospitalizations also had a diagnosis of AF. The in-hospital mortality was 2.6% in MVA alone and 7.6% in MVA and AF. In multivariate analysis, after adjustment for age, gender, Charlson Comorbidity Index (CCI), the Trauma Mortality Prediction Model (TMPM), and hospital characteristics, AF was independently associated with in-hospital mortality [Odds ratio (OR) 1.52, confidence interval (CI) 1.41-1.69, P value<0.0001]. In patients with MVA and AF, increasing age, CCI, and TMPM were associated with higher mortality. Female gender is associated with lower mortality (OR 0.84, CI 0.81-0.88, P -0.0016). Most patients with MVA and AF had a CHADS2 score of 2 (34.6%). Mortality and transfusion rates were higher in MVA and AF patients compared to patients with MVA alone across all CHADS2 scores. CONCLUSION: In patients with a MVA, the presence of AF is an independent risk factor for in-hospital mortality.
BACKGROUND: We examined the effect of AF a commonly encountered arrhythmia with significant morbidity on mortality following a motor vehicle accident (MVA) related hospitalization. METHODS: The Nationwide Inpatient Sample (NIS) was queried to identify patients with AF (ICD-9 CM 427.31) and MVA (ICD-9 CM E810.0-E819.9), considered separately and together, from 2003 through 2012. Baseline characteristics were identified and multilevel mixed model multivariate analysis was employed to verify the impact of AF on in-patient mortality in survivors. RESULTS: Of an estimated 2,978,630 MVA admissions reported, 79,687 (2.6%) hospitalizations also had a diagnosis of AF. The in-hospital mortality was 2.6% in MVA alone and 7.6% in MVA and AF. In multivariate analysis, after adjustment for age, gender, Charlson Comorbidity Index (CCI), the Trauma Mortality Prediction Model (TMPM), and hospital characteristics, AF was independently associated with in-hospital mortality [Odds ratio (OR) 1.52, confidence interval (CI) 1.41-1.69, P value<0.0001]. In patients with MVA and AF, increasing age, CCI, and TMPM were associated with higher mortality. Female gender is associated with lower mortality (OR 0.84, CI 0.81-0.88, P -0.0016). Most patients with MVA and AF had a CHADS2 score of 2 (34.6%). Mortality and transfusion rates were higher in MVA and AFpatients compared to patients with MVA alone across all CHADS2 scores. CONCLUSION: In patients with a MVA, the presence of AF is an independent risk factor for in-hospital mortality.
Authors: Sean P Nassoiy; Robert H Blackwell; McKenzie Brown; Anai N Kothari; Timothy P Plackett; Paul C Kuo; Joseph A Posluszny Journal: J Osteopath Med Date: 2021-03-10