ASSOCIATION OF TRAUMATIC BRAIN INJURY AND CARDIAC DYSRHYTHMIA: A PROPENSITY WEIGHTED ANALYSIS OF THE NATIONAL INPATIENT SAMPLE

Abstract

SESSION TITLE: Cardiovascular Disease SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Traumatic brain injury (TBI) is among the most common causes of death in trauma patients. The exact etiology of mortality is poorly understood. Catecholamine surges seen in these patients are known to prompt arrhythmogenesis. We attempted to better characterize the correlation between traumatic brain injury and arrhythmogenesis. METHODS: A composite database of National Inpatient Sample (NIS) for 2016 and 2017 was queried using ICD-10 codes to identify patients with dysrhythmia among a cohort of patients with traumatic brain injury. A propensity weighted logistic regression analysis was performed controlling for age, gender, and comorbidities. Propensity weighted cohorts were compared for correlation with dysrhythmia by age category. RESULTS: Among a cohort of 111, 280 patients with traumatic brain injury. Population average age was 58.3 +/- 0.15 years, 39.61% of whom were female. A propensity weighted logistic regression model was performed using Stata 16.1 controlling for age, gender, and comorbidity (presence of AICD, Pacemaker, history of chronic heart failure, diabetes, ischemic stroke, COPD, PVD, CKD, OSA, hypertension CAD). Patients under 40 years of age more commonly had arrhythmia in TCE and SAH whereas patients aged 40 and over more commonly had arrhythmia from SDH (Table 1). TABLE 1: Age Related Association of TBI with Dysrhythmia AGE LESS THAN 40 Diffuse TBI VT [OR 2.359, 95% CI(1.409-3.948), p=0.001], Bradyarrhythmia [OR 1.274, 95% CI(1.053-1.540), p=0.012] Focal TBI Bradyarrhythmia [OR 1.533, 95% CI(1.220-1.926), p<0.001] TCE SSS [OR 7.704, 95% CI(3.369-25.050), p=0.001], AF/AFL [OR 2.076, 95% CI(1.108-3.893), p=0.023] Bradyarrhythmia [OR 3.049, 95% CI(2.581-3.601), p<0.001] SVT [OR 2.026, 95% CI(1.021-4.022), p=0.043] VF [OR 8.081, 95% CI(4.685-13.425), p<0.001] VT [OR 5.759, 95% CI(3.663-9.054), p<0.001] SDH Bradyarrhythmia [OR 2.239, 95% CI(1.962-2.554), p<0.001] VT [OR 1.462, 95% CI(1.013-2.110), p = 0.042] SAH AF/AFL [OR 1.689, 95% CI(1.219-2.340), p=0.002] Bradyarrhythmia [OR 1.669, 95% CI(1.466-1.901), p<0.001] Type 2 AVB [OR 4.136, 95% CI(1.207-14.169),p=0.024] SVT [OR 2.144, 95% CI(1.468-3.131), p<0.001] VF [OR 2.681, 95% CI(1.534-4.684), p=0.001] VT [OR 2.292, 95% CI(1.566-3.355), p<0.001] AGE 40 OR GREATER Diffuse TBI: VT [OR 1.406, 95% CI(1.139-1.736),p=0.001] TCE VT[OR 1.467, 95% CI(1.069-2.013),p=0.018] SDH SSS[OR 1.309, 95% CI(1.121-1.528), p = 0.001] AF/AFL [OR 1.340, 95% CI(1.132-1.586), p = 0.001] Bradyarrhythmia [OR 1.318, 95% CI(1.095-1.586), p = 0.003] Type 1 AVB [OR 1.309, 95% CI(1.117-1.533),p = 0.001] Type 2 AVB[OR 1.309, 95% CI(1.112-1.541),p = 0.001] Complete Heart Block [OR 1.309, 95% CI(1.129-1.517), p<0.001] SAH VT[OR 1.326, 95% CI(1.190-1.477), p<0.001] CONCLUSIONS: Patients with TBI have a high incidence of dysrhythmia. CLINICAL IMPLICATIONS: Patients with TBI should be monitored closely for dysrhythmia. DISCLOSURES: No relevant relationships by Krishna Akella, source=Web Response No relevant relationships by Charles Arcoleo, source=Web Response No relevant relationships by Akella Chendrasekhar, source=Web Response No relevant relationships by Priscilla Chow, source=Web Response No relevant relationships by Kashif Hussain, source=Web Response No relevant relationships by Samer Ibrahim, source=Web Response No relevant relationships by Gunjan Joshi, source=Web Response No relevant relationships by Ghulam Mujtaba, source=Web Response No relevant relationships by Haaris Naji, source=Web Response No relevant relationships by Heidi Roppelt, source=Web Response No relevant relationships by Nandini Seshan, source=Web Response No relevant relationships by Howard Sklarek, source=Web Response No relevant relationships by Liana Tatarian, source=Web Response No relevant relationships by Daisy Young, source=Web Response