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Motor vehicle accidents might be more risky for atrial fibrillation patients, a national study suggested.
The inhospital mortality rate was 7.8% for atrial fibrillation patients involved in car accidents compared with 2.6% for accident victims without atrial fibrillation, , of the Mayo Clinic in Rochester, Minn., and colleagues found.
Atrial fibrillation was independently associated with a significant 52% relative increase in risk of dying in the hospital after a car accident, after adjustment for age, gender, Charlson Comorbidity Score, Injury Severity score, and hospital characteristics in the analysis of Nationwide Inpatient Sample data covering nearly 3 million car crashes, presented at the in Nice, France.
Action Points
- Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
"We should not jump the gun and advise patients with atrial fibrillation to stop driving," Deshmukh cautioned in a conference press release. "This was a retrospective observational study and needs to be confirmed by further research. Only then will we be in a position to give practical advice to patients with a higher risk."
However, he pointed to a potential mechanism for the link -- anticoagulants used to lower stroke risk but which also increase bleeding risk.
"Although we couldn't assess for anticoagulation from the database, we did see that patients with higher CHADS2 scores had higher mortality and more chances of getting blood transfusions," he noted in an email to 51˶.
The analysis included more than 2.9 million motor vehicle accident patients from 2003 through 2012, among whom 2.6% had atrial fibrillation.
Hospital stays were also longer, with a mean of 9.1 days for crash victims with atrial fibrillation versus 5.9 days without atrial fibrillation, and more expensive, at a mean of $28,217 versus $19,615, respectively. Both differences were statistically significant and remained so on multivariable analysis.
The combination of a motor vehicle accident and pre-existing atrial fibrillation was associated with greater risk of mortality with increasing age and higher Charlson Comorbidity Scores.
From the American Heart Association:
Disclosures
Deshmukh and co-authors disclosed no relevant relationships with industry.
Primary Source
CARDIOSTIM-EUROPACE
Deshmukh A, et al "Impact of atrial fibrillation on patients with motor vehicle accidents" CARDIOSTIM-EUROPACE 2016.