Rovshan M Ismailov, MD MPH¹, Harold B. Weiss, MPH, PhD², Roberta B Ness, MD, MPH³, Bruce A. Lawrence, PhD⁴, and Ted Miller, Ph D⁴. (1) Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, P.O. Box 19122, Pittsburgh, PA 15213, 412 969 6881, rovshani@yahoo.com, (2) Center for Injury Research and Control, University of Pittsburgh, 200 Lothrop St., Suite B400, Pittsburgh, PA 15213, (3) Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, 130 DeSoto street, Pittsburgh, PA 15213, (4) Pacific Institute for Research and Evaluation, 11710 Beltsville Drive, Suite 300, Calverton, MD 20705-3102

Introduction. Injuries and congestive heart failure are two major public health issues. Cardiac injury has been well recognized as a complication of blunt chest trauma. Its clinical spectrum ranges from blunt cardiac injury (BCI) to complete rupture of cardiac tissues, with cardiac valvular injury often being overlooked. Objective. To determine whether hospitalized BCI is associated with increased risk of cardiac valve insufficiency in a large multistate population. Methods. Cases with BCI and cardiac valve insufficiency were identified based on discharge diagnoses in 1997 statewide hospital discharge data from 19 states. Four valvular outcomes were studied: (1) mitral valve insufficiency, incompetence, regurgitation (MVIIR); (2) aortic valve insufficiency, incompetence, regurgitation, stenosis (AVIIRS); (3) tricuspid valve insufficiency, incompetence, regurgitation, stenosis (TVIIRS); and (4) pulmonary valve insufficiency, incompetence, regurgitation, stenosis (PVIIRS). Results. Among 1,051,081 injury discharges, 2,709 (0.26%) people had BCI; 13,087 (1.25%) had MVIIR; 9,811 (0.93%) had AVIIRS; 1,338 (0.13%) had TVIIRS; 178 (0.02%) had PVIIRS. Independent of potential confounding factors, discharge for BCI was associated with a 12-fold increased risk for TVIIRS and a 3.4-fold increased risk for AVIIRS. Conclusion. Cardiac valve insufficiency has been well recognized as an important risk factor for congestive heart failure. With the findings that BCI is associated with an increased risk of specific valvular disorders, it is possible that trauma may play an important and heretofore largely unrecognized role in a portion of the burden of cardiovascular morbidity and mortality.

Learning Objectives: At the conclusion of the sessions the participant will be able to

• Identify how ICD-9-CM is used in hospital discharge data.
• Recognize the importance of blunt cardiac injury
• Recognize the existance of the link between trauma and chronic disease

Keywords: Injury, Heart Disease

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.