@article{ref1,
title="Traumatic injury and atrial fibrillation among deployed service members",
journal="Journal of cardiovascular electrophysiology",
year="2021",
author="Alcover, Karl C. and Ambardar, Shiva R. and Poltavskiy, Eduard and Nasir, Javed M. and Janak, Jud C. and Howard, Jeffrey T. and Walker, Lauren E. and Haigney, Mark C. and Stewart, Ian J.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: Atrial Fibrillation and Atrial Flutter (AF/AFL), the most common atrial arrhythmias, have never been examined in combat casualties. In this study, we investigated the impact of traumatic injury on AF/AFL among service members with deployment history. <br><br>METHODS: Sampled from the Department of Defense (DoD) Trauma Registry (n=10,000), each injured patient in this retrospective cohort study was matched with a non-injured service member drawn from the Veterans Affairs/DoD Identity Repository. The primary outcome was AF/AFL diagnosis identified using ICD-9-CM and ICD-10-CM codes. Competing risk regressions based on Fine and Gray subdistribution hazards model with were utilized to assess the association between injury and AF/AFL. <br><br>RESULTS: There were 130 reported AF/AFL cases, 90 of whom were injured and 40 were non-injured. The estimated cumulative incidence rates of AF/AFL for injured was higher compared to non-injured patients (HR = 2.04; 95% CI = 1.44, 2.87). After adjustment demographics and tobacco use, the association did not appreciably decrease (HR = 1.90; 95% CI = 1.23, 2.93). Additional adjustment for obesity, hypertension, diabetes, and vascular disorders, the association between injury and AF/AFL was no longer statistically significant (HR: 1.51; 95% CI = 0.99, 2.52). <br><br>CONCLUSION: Higher AF/AFL incidence rate was observed among deployed service members with combat injury compared to servicemembers without injury. The association did not remain significant after adjustment for cardiovascular-related covariates. These findings highlight the need for combat casualty surveillance to further understand the AF/AFL risk within the military population and to elucidate the potential underlying pathophysiologic mechanisms. UNSTRUCTURED ABSTRACT: Atrial fibrillation and atrial flutter have never been examined in combat casualties. In this study, we investigated the impact of traumatic injury on AF/AFL among service members with deployment history. A retrospective cohort of injured patients (n =10,000) was sampled from the Department of Defense (DoD) Trauma Registry. Each injured patient was matched with a non-injured service member drawn from the Veterans Affairs/DoD Identity Repository. The AF/AFL diagnosis was identified using ICD-9-CM and ICD-10-CM codes. To assess the association between injury and AF/AFL, competing risk regressions based on Fine and Gray subdistribution hazards model were utilized. In this cohort, 130 patients were reported AF/AFL cases (90 were injured and 40 were non-injured). The incidence rate of AF/AFL for injured was higher compared to non-injured patients (HR = 2.04; 95% CI = 1.44, 2.87). After adjustment for demographics and tobacco use, the association did not appreciably decrease (HR = 1.90; 95% CI = 1.23, 2.93). Additional adjustment for obesity, hypertension, diabetes, and vascular disorders, the association between injury and AF/AFL was no longer statistically significant (HR: 1.51; 95% CI = 0.99, 2.52). Higher AF/AFL incidence rate was observed among deployed service members with combat injury compared to service members without injury. The association did not remain significant after adjustment for cardiovascular-related covariates. These findings highlight the need for combat casualties surveillance to further understand the AF/AFL risk within the military population and to elucidate the potential underlying pathophysiologic mechanisms. This article is protected by copyright. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1045-3873",
doi="10.1111/jce.15139",
url="http://dx.doi.org/10.1111/jce.15139"
}