Sarah A King, Jacob D Jenkins, James Livesay, Ji-Ming Yune, Elizabeth Mannino, Jason M Webb, Haddon C Hill, Raj Baljepally, Brian J Daley, Lou M Smith

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

  • Surgery

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, STEMI, NSTEMI, CHF, pulmonary edema, cardiac arrest, cardiogenic shock, and cardiac mortality). Univariate and bivariate analyses were performed. Results: 569 patients had a chest CT – 12 were excluded due to missing CAC severity. Of 557 patients, 442 (79.3%) had NM-CAC and 115 (20.7%) MS-CAC; MS-CAC were older (73.3 vs 67.4 years) with fewer males (48.7% vs 54.5%), and had higher cardiac related comorbidities, and had higher AIS chest injury scores. MS-CAC had an increased rate of CC (odds ratio [OR] 1.81, p=0.016). Cardiac complications statistically more common in MS-CAC were CHF (OR 3.41, p=0.003); cardiogenic shock (OR 3.3, p=0.006); NSTEMI or II (OR 2.8, p=0.017); and 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.

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