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Erschienen in:
01.03.2006 | Original
Atrial fibrillation in trauma patients requiring intensive care
Erschienen in: Intensive Care Medicine | Ausgabe 3/2006
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Objectives
To evaluate the incidence and risk factors of atrial fibrillation (AF) in trauma patients.
Design and setting
Prospective observational study in a surgical intensive care unit (ICU).
Patients
All trauma patients admitted in the surgical ICU except those who had AF at admission.
Measurements and results
AF occurred in 16/293 patients (5.5%). AF patients were older, had a higher
number of regions traumatized, and received more fluid therapy, transfusion
products, and catecholamines. They more frequently experienced systemic
inflammatory response syndrome, sepsis, shock, and acute renal failure and
had higher scores of severity (Simplified Acute Physiology Score, SAPS II;
Injury Severity Score). ICU length of stay and resources use were also
increased. ICU and hospital mortality rates were twice higher in AF patients
whereas standardized mortality ratio (observed/expected mortality by SAPS
II) was similar in the two groups. We found five independent risk factors of
developing AF: catecholamine use (OR = 5.7, 95% CI 1.7–19.1), SAPS II of 30 or higher (OR = 11.6, 95% CI 1.3–103.0), three or more regions traumatized
(OR = 6.2, 95% CI 1.8–21.4), age 40 years or higher (OR = 6.3, CI 1.4–28.7), and
systemic inflammatory response syndrome (OR = 4.4, 95% CI 1.2–16.1).
Conclusions
In addition to age and catecholamine use, inflammation and severity of
injury may be involved in the development of AF in trauma patients. Our
results suggest that AF could rather be a marker of a higher severity of
illness without major effect on mortality.