Mina F Mirhoseini1, Susan E Hamblin2, W Paul Moore2, Jonathan Pouliot2, Judith M Jenkins1, Wei Wang3, Rameela Chandrasekhar4, Bryan R Collier5, Mayur B Patel6. 1. Vanderbilt University Medical Center, Section of Surgical Sciences, Department of Surgery, Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Nashville, Tennessee. 2. Vanderbilt University Medical Center, Department of Pharmaceutical Services, Nashville, Tennessee. 3. Vanderbilt University Medical Center, Department of Biostatistics, Nashville, Tennessee; Data Scientist at Intuit, Inc. at Mountain View, California. 4. Vanderbilt University Medical Center, Department of Biostatistics, Nashville, Tennessee. 5. Vanderbilt University Medical Center, Section of Surgical Sciences, Department of Surgery, Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Nashville, Tennessee; Roanoke Memorial Hospital, Carillon Clinic, Division of Trauma, Department of Surgery; Virginia Tech Carilion School of Medicine, Edward Via Virginia College of Osteopathic Medicine, Roanoke, Virginia. 6. Vanderbilt University Medical Center, Section of Surgical Sciences, Department of Surgery, Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Nashville, Tennessee; Vanderbilt University Medical Center, Departments of Neurosurgery, and Speech & Hearing Sciences, Vanderbilt Brain Institute, Center for Health Services Research; Vanderbilt University School of Medicine; Geriatric Research, Education and Clinical Center Service, Surgical Services, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee. Electronic address: mayur.b.patel@vanderbilt.edu.
Abstract
BACKGROUND: The purpose of this study is to determine if antioxidant supplementation influences the incidence of atrial arrhythmias in trauma intensive care unit (ICU) patients. MATERIALS AND METHODS: In this retrospective pre-post study, critically ill injured patients aged ≥18 years, admitted to a single-center trauma ICU for ≥48 hours were eligible for inclusion. The control group consists of patients admitted from January 2000 to September 2005, before routine antioxidant supplementation in our ICU. The antioxidant group consists of patients admitted from October 2005 to June 2011 who received an antioxidant protocol for ≥48 hours. The primary outcome is the incidence of atrial arrhythmias in the first 2 weeks of hospitalization or before discharge. RESULTS: Of the 4699 patients, 1622 patients were in the antioxidant group and 2414 patients were in the control group. Adjusted for age, sex, year, injury severity, past medical history, and medication administration, the unadjusted incidence of atrial arrhythmias was 3.02% in the antioxidant group versus 3.31% in the control group, with no adjusted difference in atrial arrhythmias among those exposed to antioxidants (odds ratio: 1.31 [95% confidence interval: 0.46, 3.75], P = 0.62). Although there was no change in overall mortality, the expected adjusted survival of patients in those without antioxidant therapy was lower (odds ratio: 0.65 [95% confidence interval: 0.43, 0.97], P = 0.04). CONCLUSIONS: ICU antioxidant supplementation did not decrease the incidence of atrial arrhythmias, nor alter the time from admission to development of arrhythmia. A longer expected survival time was observed in the antioxidant group compared with the control group but without a change in overall mortality between groups. Published by Elsevier Inc.
BACKGROUND: The purpose of this study is to determine if antioxidant supplementation influences the incidence of atrial arrhythmias in trauma intensive care unit (ICU) patients. MATERIALS AND METHODS: In this retrospective pre-post study, critically ill injured patients aged ≥18 years, admitted to a single-center trauma ICU for ≥48 hours were eligible for inclusion. The control group consists of patients admitted from January 2000 to September 2005, before routine antioxidant supplementation in our ICU. The antioxidant group consists of patients admitted from October 2005 to June 2011 who received an antioxidant protocol for ≥48 hours. The primary outcome is the incidence of atrial arrhythmias in the first 2 weeks of hospitalization or before discharge. RESULTS: Of the 4699 patients, 1622 patients were in the antioxidant group and 2414 patients were in the control group. Adjusted for age, sex, year, injury severity, past medical history, and medication administration, the unadjusted incidence of atrial arrhythmias was 3.02% in the antioxidant group versus 3.31% in the control group, with no adjusted difference in atrial arrhythmias among those exposed to antioxidants (odds ratio: 1.31 [95% confidence interval: 0.46, 3.75], P = 0.62). Although there was no change in overall mortality, the expected adjusted survival of patients in those without antioxidant therapy was lower (odds ratio: 0.65 [95% confidence interval: 0.43, 0.97], P = 0.04). CONCLUSIONS: ICU antioxidant supplementation did not decrease the incidence of atrial arrhythmias, nor alter the time from admission to development of arrhythmia. A longer expected survival time was observed in the antioxidant group compared with the control group but without a change in overall mortality between groups. Published by Elsevier Inc.
Authors: Benjamin A Steinberg; Yue Zhao; Xia He; Adrian F Hernandez; David A Fullerton; Kevin L Thomas; Roger Mills; Winslow Klaskala; Eric D Peterson; Jonathan P Piccini Journal: Clin Cardiol Date: 2013-12-18 Impact factor: 2.882
Authors: Peter J D Andrews; Alison Avenell; David W Noble; Marion K Campbell; Bernard L Croal; William G Simpson; Luke D Vale; Claire G Battison; David J Jenkinson; Jonathan A Cook Journal: BMJ Date: 2011-03-17