AF elevates risk for death from motor vehicle accidents

Atrial fibrillation increased the risk for death from motor vehicle accidents and contributed to longer, costlier hospital stays and more bleeding episodes for survivors, according to study results presented at Cardiostim–EHRA Europace 2016 in Nice, France.

Abhishek Deshmukh, MD, an electrophysiologist at Mayo Clinic in Rochester, Minnesota, told Cardiology Today in an interview that medications taken by those with AF contribute to the higher death rate.

Abhishek Deshmukh

“Many of these patients are on anticoagulants or blood thinners to prevent stroke, and the cause of death is due to blood loss from trauma,” Deshmukh said. “Often, there are comorbidities other than AF contributing to these terrible outcomes.”

The study cohort was 2,978,630 drivers, passengers and bystanders who required hospitalization due to a motor vehicle accident from 2003 to 2012. Data were taken from Nationwide Inpatient Sample. Among the patients studied, 79,687 (2.6%) had AF.

Researchers found that the in-hospital mortality rate was 1.1% for those with AF alone, 2.6% for those who had motor-vehicle accidents and 7.6% for those with AF who had a motor vehicle accident. When adjusted for age, sex, comorbidities and injury-severity scores, patients with AF were 1.5 times more likely to die of motor vehicle accidents than those without AF (OR = 1.62; 95% CI 1.56-1.68), according to the researchers.

Researchers also found that the mean cost of being hospitalized for a motor vehicle accident was $19,615 for those without AF compared with $28,217 for those with AF (P < .001). The mean length of hospital stay for a motor vehicle accident for those without AF was 5.9 days compared with 9.1 days for those with AF (P < .001), resulting in a mean longer hospital stay of 2.4 days and a mean higher hospital cost of $7,406 for those with AF (P < .0001 for both).

Among those with AF who had a motor vehicle accident, those with advanced age and a high Charlson comorbidity index score had a higher mortality rate, according to the researchers.

Deshmukh told Cardiology Today that although more research is needed, those with AF should not stop driving.

“AF is a complex disease,” he said. “We already know that patients with AF admitted to a hospital for other conditions such as hip replacement, bypass surgery and septic shock die at a higher rate than those without AF. This issue needs to be assessed even more systematically. We should seek out data from other countries and consider a prospective study.” – by James Clark

Reference:

Deshmukh A, et al. Poster 216-29. Presented at Cardiostim–EHRA Europace 2016; June 8-11, 2016; Nice, France.

Disclosure: Deshmukh reports no relevant financial disclosures.