Incidence and Risk Factors of Developing a Dysrhythmia After Blunt Thoracic Trauma

Background/Objectives: The incidence of dysrhythmia after blunt thoracic trauma varies in the literature from 8-75%, and the complication rate from these dysrhythmias is not well studied. The aims of this study are to (1) identify the incidence of dysrhythmia following blunt thoracic trauma, (2) identify risk factors associated with developing a dysrhythmia, and (3) identify the incidence of cardiac intervention after developing a dysrhythmia. We hypothesize that blunt thoracic trauma may result in post-injury dysrhythmias. Methods: This is a retrospective review of trauma patients ≥ 18 years with a blunt mechanism of injury at a Level 1 Trauma Center from 1/2010 to 3/2022. Patients were included if they had one of the following: rib fracture, sternal fracture, chest wall contusion, pneumothorax, hemothorax, chest pain, chest wall deformity, or chest wall crepitus. Patients were excluded if they had an Abbreviated Injury Scale Chest = 0 or if they had a pre-existing dysrhythmia. Univariate, multivariate, and multivariable statistical analyses were performed. Results: In total, 2943 patients met inclusion criteria. In total, 574 (19.5%) developed a dysrhythmia; 100 (17.4%) required a new antiarrhythmic at discharge. Patients who developed a dysrhythmia had a nearly two times greater likelihood of requiring cardiac intervention than those without a dysrhythmia (AOR: 1.79; p = 0.004). Additional risk factors for requiring cardiac intervention included Injury Severity Score (ISS) 16-25 and >25 (p < 0.001). Conclusions: The incidence of dysrhythmia after blunt thoracic injury is 19.5% at our level I trauma center. Based on our study, patients that were older, had an ISS > 25, had a history of previous cardiac disease, or required > 5 units of blood products were at an increased risk of developing a dysrhythmia following trauma. As such, future consideration should be given to extended guidelines in monitoring these vulnerable patients.