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Atrial Fibrillation in Elderly (Age > 65 Years) Trauma Patients is Associated With Increased Mortality and Morbidity
Cardiovascular Disease SESSION TITLE: Cardiovascular 2 SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM
Atrial Fibrillation in Elderly (Age > 65 Years) Trauma Patients is Associated With Increased Mortality and Morbidity Krishna Akella* Sraavya Akella Sai Lekshmi Akella and Akella Chendrasekhar Stony Brook Southampton Hospital, Southampton, NY PURPOSE: Atrial Fibrillation (AF), is the most common dysrhythmia in elderly Trauma patients. At our level 1 trauma center, we compared outcomes in elderly trauma patients with AF versus patients without AF. We also looked at the effect of rapid ventricular response[rate greater than 100, RVR] on outcomes in patients with AF.
CARDIOVASCULAR DISEASE
METHODS: A retrospective data analysis was performed comparing patients over the age of 65, who had AF with RVR to patients without RVR and patients not in 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). RESULTS: 205 patients were enrolled, 38 with AF with RVR and 167 without AF or in AF without RVR. Overall complication rates were found to be greater for patients with RVR with regard to hospital length of stay (days) (8.8 vs. 12.8, p = .02), ICU length of stay (days) (4.5 vs. 8.2, p=.01), and ventilator days (1.7 vs. 5.6, p = .007), and Survival to hospital discharge(89.8% vs. 71.0%, p = .002). Difference in ISS was insignificant. 36/38 patients developed rapid ventricular response [HR > 120 /min] at some point during their ICU stay. Patients with AF developed pneumonia at a greater rate than patients without AF (47.3 % versus 4.2 % , p< 0.0001). CONCLUSIONS: Of elderly patients with RVR, the in hospital morbidity including hospital length of stay, ICU length of stay, ventilator days, pneumonia rate and mortality was significantly greater than patients without AF or RVR. CLINICAL IMPLICATIONS: Atrial fibrillation with rapid ventricular response is associated with worse outcomes (pneumonia rate, ventilator days, icu, hospital length of stay and mortality) in elderly critically ill trauma patients. DISCLOSURE: The following authors have nothing to disclose: Krishna Akella, Sraavya Akella, Sai Lekshmi Akella, Akella Chendrasekhar No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2017.08.096
Copyright ª 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
66A
[
152#4S CHEST OCTOBER 2017
]
Atrial Fibrillation in Elderly (Age > 65 Years) Trauma Patients is Associated With Increased Mortality and Morbidity Krishna Akella* Sraavya Akella Sai Lekshmi Akella and Akella Chendrasekhar Stony Brook Southampton Hospital, Southampton, NY PURPOSE: Atrial Fibrillation (AF), is the most common dysrhythmia in elderly Trauma patients. At our level 1 trauma center, we compared outcomes in elderly trauma patients with AF versus patients without AF. We also looked at the effect of rapid ventricular response[rate greater than 100, RVR] on outcomes in patients with AF.
CARDIOVASCULAR DISEASE
METHODS: A retrospective data analysis was performed comparing patients over the age of 65, who had AF with RVR to patients without RVR and patients not in 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). RESULTS: 205 patients were enrolled, 38 with AF with RVR and 167 without AF or in AF without RVR. Overall complication rates were found to be greater for patients with RVR with regard to hospital length of stay (days) (8.8 vs. 12.8, p = .02), ICU length of stay (days) (4.5 vs. 8.2, p=.01), and ventilator days (1.7 vs. 5.6, p = .007), and Survival to hospital discharge(89.8% vs. 71.0%, p = .002). Difference in ISS was insignificant. 36/38 patients developed rapid ventricular response [HR > 120 /min] at some point during their ICU stay. Patients with AF developed pneumonia at a greater rate than patients without AF (47.3 % versus 4.2 % , p< 0.0001). CONCLUSIONS: Of elderly patients with RVR, the in hospital morbidity including hospital length of stay, ICU length of stay, ventilator days, pneumonia rate and mortality was significantly greater than patients without AF or RVR. CLINICAL IMPLICATIONS: Atrial fibrillation with rapid ventricular response is associated with worse outcomes (pneumonia rate, ventilator days, icu, hospital length of stay and mortality) in elderly critically ill trauma patients. DISCLOSURE: The following authors have nothing to disclose: Krishna Akella, Sraavya Akella, Sai Lekshmi Akella, Akella Chendrasekhar No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2017.08.096
Copyright ª 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
66A
[
152#4S CHEST OCTOBER 2017
]