Akella Chendrasekhar
Among elderly trauma patients (age > 65), atrial fibrillation
(AF) is the most common arrhythmia. Although
there is evidence to suggest poor outcomes in patients
who develop rapid ventricular response (RVR), there is a
paucity of more generalizable data on outcomes for trauma
patients with atrial fibrillation. At our level 1 trauma
center, we sought to evaluate the clinical effects of AF in
elderly trauma patients.
A retrospective data analysis was performed comparing
patients over the age of 65 with AF to patients without
AF. Data obtained included hospital length of stay, ICU
length of stay, Injury Severity Score (ISS), ventilator days,
and survival. Data were analyzed with one-way analysis of
variance (ANOVA). 205 patients were enrolled, 44 with
AF and 161 without AF. Patients with AF were found to
have greater hospital length of stay (days) (8.0 vs. 15.2,
p < 0.0001), ICU length of stay (days) (4.2 vs. 9.0, p =
0.0006), and survival to hospital discharge (77.2% vs.
90.7%, p = 0.016). Although there was a trend to suggest
greater number of ventilator days among patients with
atrial fibrillation, this was found to be not statistically significant.
There was no difference in injury severity score
between the 2 groups.
The in hospital morbidity including hospital length of
stay, ICU length of stay, and mortality was significantly
greater for elderly trauma patients with atrial fibrillation
than for those without.