Older age is the strongest predictor of postoperative atrial fibrillation Meeting Abstract

  


Authors: Amar, D.; Zhang, H.; Leung, D.; Roistacher, N.; Kadish, A.
Abstract Title: Older age is the strongest predictor of postoperative atrial fibrillation
Meeting Title: 2001 Annual Meeting of the American Society of Anesthesiologists
Abstract: Background: Our goal was to evaluate the accuracy of easily available clinical characteristics for the prediction of atrial fibrillation/flutter(AF) after major thoracic surgery. Methods: Patients undergoing major elective thoracic surgery were included in the present study from an ongoing prospective database. Results: Postoperative in-hospital AF occurred in 86 (16%) of 534 patients. Maximum P-wave duration as measured from standard ECG did not differentiate patients who did or did not develop AF. Using cutpoint methodology and logistic regression we identified two preoperative risk factors independently associated with AF: age gtoreq 60 yr. (P=.0007) and baseline heart rate gtoreq74 bpm(P=.005). The odds of developing AF increased by a factor of 2.5 (95% CI,1.7 to 3.4, P < .0001) between incremental age categories (<60 yr., 60-69 yr., gtoreq 70 yr.) and by a factor of 2.3 (95% CI,1.4 to 3.8, P < .0007) in patients with a baseline heart rate gtoreq 74 bpm. The combination of age gtoreq 60 yr. and baseline heart rate gtoreq 74 bpm predicted AF with a sensitivity of 73% and specificity of 57%. Patients who developed AF had a higher incidence of postoperative pneumonia (14% vs. 4%, P=.001), acute respiratory failure (7% vs. 1.6%, P=.01) and were more likely to remain hospitalized (RR=1.4, 16 +- 17 d. vs. 10 +- 9 d, P=.002) when compared to those who did not develop AF, respectively. Conclusions: Advanced age and preoperative heart rate identify patients at high risk for development of AF after thoracic surgery. Postoperative AF occurs more frequently in patients with greater postoperative morbidity and length of hospitalization.
Keywords: heart rate
Journal Title: Anesthesiology Abstracts of Scientific Papers Annual Meeting
Issue: 2001
Meeting Dates: 2001 Oct 13-17
Meeting Location: New Orleans, LA
Publisher: American Society of Anesthesiologists  
Date Published: 2002-01-01
Language: English
ACCESSION: BCI:BCI200300108991
PROVIDER: biosis
Notes: Meeting Abstract: A-145 -- 2001 Annual Meeting of the American Society of Anesthesiologists -- New Orleans, LA, USA -- October 13-17, 2001 -- American Society of Anesthesiologists Inc. -- Source: Biosis