Cardiac Arrhythmias in Trauma Patients Undergoing Pericardiotomy: A Retrospective Analysis

Abstract

Introduction: Pericardiotomy is performed in the setting of trauma to diagnose and treat cardiac injury. The frequency of cardiac arrhythmia after pericardiotomy for trauma is poorly described in the literature. We sought to identify the frequency of and risk factors for the development of postpericardiotomy arrhythmia in trauma patients.

Materials and methods: We performed a retrospective single-center cohort study of patients >16 y of age, querying our institutional trauma database (Jan 2011-Dec 2020) for International Classification of Diseases-9 and -10 codes involving pericardiotomy (i.e., pericardial window, sternotomy). Operative details and postoperative course were collected for patients surviving >24 h. Sinus bradycardia and tachycardia were not included as arrhythmias.

Results: We identified 252 trauma patients who underwent pericardiotomy. One hundred fifty-four patients survived >24 h. Of these, 12.3% experienced arrhythmia. Patients developing arrhythmia were older, had higher injury severity score, were more likely to have a blunt mechanism of injury, and had higher in-hospital mortality. On multiple logistic regressions, increasing age, blunt mechanism, and concomitant laparotomy were associated with arrhythmia development, while operative characteristics were not.

Conclusions: At our institution, trauma patients undergoing pericardiotomy have a risk of arrhythmia of 12.3%, which is associated with multiple nonmodifiable risk factors. Further study is warranted to identify potential mechanisms to reduce arrhythmias in this population.

Keywords: Pericardiotomy; Postoperative arrhythmia; Trauma surgery.