• Philippe Seguin, Bruno Laviolle, Axelle Maurice, Christophe Leclercq, and Yannick Mallédant.
• Hôpital Pontchaillou, Surgical Intensive Care Unit, 2 rue Henri le Guilloux, Rennes Cedex 9, 35033 Rennes, France. philippe.seguin@chu-rennes.fr
• Intensive Care Med. 2006 Mar 1;32(3):398-404.

ObjectivesTo evaluate the incidence and risk factors of atrial fibrillation (AF) in trauma patients.Design And SettingProspective observational study in a surgical intensive care unit (ICU).PatientsAll trauma patients admitted in the surgical ICU except those who had AF at admission.Measurements And ResultsAF 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).ConclusionsIn 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.

14 keywords...

hide…