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APHA Scientific Session and Event Listing

Trauma associated with cardiac dysrhythmias: Results from large matched case-control study

Rovshan M. Ismailov, MD, MPH, PhD1, Roberta B. Ness, MD MPH1, Carol K. Redmond, ScD2, Evelyn O. Talbott, PhD1, and Harold (Hank) B. Weiss, PhD MPH3. (1) Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, P.O. Box 19122, Pittsburgh, PA 15213, 412 969 6881, rovshani@yahoo.com, (2) Department of Biostatistics, Graduate School of Public Health University of Pittsburgh, 318A Parran Hall 130 DeSoto street, Pittsburgh, PA 15261, (3) Department of Neurological Surgery, Center for Injury Research and Control University of Pittsburgh, 200 Lothrop street Suite B-400, Pittsburgh, PA 15213

Background. Various cardiac dysrhythmias such as supraventricular and ventricular premature beats, supraventricular and ventricular paroxysmal tachycardia, atrial and ventricular fibrillation and atrial flutter have been reported, in case series, as complications of blunt cardiac and thoracic trauma. The objective of this research was to determine whether thoracic or blunt cardiac injury is associated with cardiac dysrhythmia in a large multi-state hospitalized population. Methods. Cases and matched (by age) controls were identified based on hospital discharge information that was collected from 986 acute general hospitals across 33 states in 2001. Both the exposure (thoracic trauma and blunt cardiac injury) and the outcome (cardiac dysrhythmias) were identified based on ICD-9-CM discharge diagnoses. Unadjusted and conditional adjusted (for gender, race, length of stay and primary source of payment) multivariate logistic regression analyses were performed. Results. After adjusting for potential confounders, patients 50 years and younger diagnosed with blunt cardiac injury had 4-fold [95% confidence interval (CI), 1.40; 11.60] increase in the risk of cardiac dysrhythmia. Independent of potential confounding factors, discharge for blunt cardiac injury among patients 51 to 70 years was associated with a 2-fold [95% CI, 1.36-3.82] increased risk for cardiac dysrhythmia. Conclusion. Blunt cardiac injury was found to be a significant risk factor for cardiac dysrhythmia. Longitudinal studies are needed to better establish the association between trauma and cardiac dysrhythmias.

Learning Objectives:

Keywords: Emergency, Injury

Presenting author's disclosure statement:

Any relevant financial relationships? No

Emergency and Disater Preparedness I

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA