Impact of atrial fibrillation on outcomes with motor vehicle accidents

Kanishk Agnihotri, N. V. Pothineni, Paris Charilaou, Vaibhav R. Vaidya, Badal Thakkar, Vishal Goyal, Sabeeda Kadavath, Nileshkumar Patel, Apurva Badheka, Peter Noseworthy, Suraj Kapa, Paul Andrew Friedman, Bernard Gersh, Hakan Paydak, Abhishek Deshmukh

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalInternational Journal of Cardiology
DOIs
StateAccepted/In press - 2017

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Keywords

  • Atrial fibrillation
  • Mortality
  • Motor vehicle accident
  • Nationwide inpatient sample

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Agnihotri, K., Pothineni, N. V., Charilaou, P., Vaidya, V. R., Thakkar, B., Goyal, V., Kadavath, S., Patel, N., Badheka, A., Noseworthy, P., Kapa, S., Friedman, P. A., Gersh, B., Paydak, H., & Deshmukh, A. (Accepted/In press). Impact of atrial fibrillation on outcomes with motor vehicle accidents. International Journal of Cardiology. https://doi.org/10.1016/j.ijcard.2017.10.002