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Abstract

Introduction: Antioxidant supplementation has been shown to decrease post-operative atrial fibrillation in cardiac surgery patients. A high-dose antioxidant supplementation protocol of ascorbic acid, selenium, and vitamin E for 7 days was implemented at our institution in October 2005 for patients admitted to the Trauma ICU. Previous studies in trauma patients demonstrated that antioxidant supplementation decreases mortality and hospital/ICU length of stay. The purpose of this study is to determine if the incidence of atrial arrhythmias is reduced in trauma patients receiving high-dose antioxidant supplementation. Hypothesis: We hypothesize that antioxidant supplementation decreases the incidence of atrial arrhythmias in trauma patients. Methods: In this single-center, retrospective cohort study at Vanderbilt University Medical Center, patients?18 years of age and admitted to the Trauma ICU for? 48 hours were eligible for inclusion. The antioxidant group consists of patients admitted from October 2005 to June 2011 who received the antioxidant protocol for? 48 hours. The control group consists of patients admitted from January 2000 to September 2005, prior to antioxidant supplementation. Patients experiencing arrhythmias were identified by ICD-9 codes. The primary outcome is the incidence of atrial arrhythmias in the first two weeks of hospitalization or prior to discharge. Results: There were 4,691 patients in this study (1,622 patients in the antioxidant group and 2,414 patients in the control group). The incidence of atrial arrhythmias was 3.02% in the antioxidant group versus 3.31% in the control group (P = 0.096; Adj OR[95% CI]: 1.64 [0.92, 2.93]). There was no difference in the average time to arrhythmia occurrence. The expected survival time of patients in the control group was decreased compared to those receiving antioxidant therapy (Adj TR[95% CI]: 0.65 [0.43, 0.97]). Conclusions: The high-dose antioxidant protocol did not significantly decrease the incidence of atrial arrhythmias in trauma patients. This study confirmed the benefit of decreased hospital mortality seen in previous studies of antioxidant supplementation at our institution.