Coronary Artery Calcification and Risk of Cardiac Complication in Geriatric Trauma Population.

Autor:	King SA; From the Departments of Surgery (King, Jenkins, Yune, Daley, Smith)., Jenkins JD; From the Departments of Surgery (King, Jenkins, Yune, Daley, Smith)., Livesay J; Cardiology (Livesay, Baljepally), University of Tennessee Medical Center-Knoxville, Knoxville, TN., Yune JM; From the Departments of Surgery (King, Jenkins, Yune, Daley, Smith)., Mannino E; Department of Surgery (Mannino)., Webb JM; East Tennessee State University Quillen College of Medicine (Webb, Hill), Johnson City, TN., Hill HC; East Tennessee State University Quillen College of Medicine (Webb, Hill), Johnson City, TN., Baljepally R; Cardiology (Livesay, Baljepally), University of Tennessee Medical Center-Knoxville, Knoxville, TN., Daley BJ; From the Departments of Surgery (King, Jenkins, Yune, Daley, Smith)., Smith LM; From the Departments of Surgery (King, Jenkins, Yune, Daley, Smith).
Jazyk:	angličtina
Zdroj:	Journal of the American College of Surgeons [J Am Coll Surg] 2024 Apr 01; Vol. 238 (4), pp. 762-767. Date of Electronic Publication: 2024 Mar 15.
DOI:	10.1097/XCS.0000000000000945
Abstrakt:	Background: Better means of identifying patients with increased cardiac complication (CC) risk is needed. Coronary artery calcification (CAC) is reported on routine chest CT scans. We assessed the correlation of CAC and CCs in the geriatric trauma population. Study Design: A prospective, observational study of patients 55 years and older who had chest CT scan from May to September 2022 at a level 1 trauma center. Radiologists scored CAC as none, mild, moderate, or severe. None-to-mild CAC (NM-CAC) and moderate-to-severe CAC (MS-CAC) were grouped and in-hospital CCs assessed (arrhythmia, ST elevation myocardial infarction [STEMI], non-STEMI, congestive heart failure, pulmonary edema, cardiac arrest, cardiogenic shock, and cardiac mortality). Univariate and bivariate analyses were performed. Results: Five hundred sixty-nine patients had a chest CT, of them 12 were excluded due to missing CAC severity. Of 557 patients, 442 (79.3%) had none-to-mild CAC and 115 (20.7%) has MS-CAC; the MS-CAC group was older (73.3 vs 67.4 years) with fewer male patients (48.7% vs 54.5%), had higher cardiac-related comorbidities, and had higher abbreviated injury scale chest injury scores. The MS-CAC group had an increased rate of CC (odds ratio [OR] 1.81, p = 0.016). Cardiac complications statistically more common in MS-CAC were congestive heart failure (OR 3.41, p = 0.003); cardiogenic shock (OR 3.3, p = 0.006); non-STEMI I or II (OR 2.8, p = 0.017); STEMI (OR 5.9, p = 0.029); and cardiac-caused mortality (OR 5.27, p = 0.036). No statistical significance between pulmonary edema (p = 0.6), new-onset arrhythmia (p = 0.74), or cardiac arrest (p = 0.193). Conclusions: CAC as reported on chest CT scans demonstrates a significant correlation with CC and should warrant additional cardiac monitoring.
Databáze:	MEDLINE
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