Frequency and risk factors of atrial fibrillation after acute abdominal surgery: A prospective cohort study
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Background and Aim: Scarce data exist on the true incidence of postoperative atrial fibrillation (POAF) after acute abdominal surgery and associated outcomes. The current study aimed to identify the frequencies of clinically recognized POAF and associated complications, along with their risk factors. Methods: This study was a prospective, single-center cohort study of unselected adult patients referred for acute abdominal surgery during a 3-month period. Through careful review, demographics, comorbidity, and surgical characteristics were prospectively drawn from medical charts. The primary outcome was clinically recognized POAF occurring in-hospital. Logistic regression was used to determine the risk factors of POAF and associated complications. A subgroup was enrolled in a feasibility study of peri- and postoperative continuous cardiac rhythm monitoring. Results: In total, 450 patients were enrolled. Clinically recognized in-hospital POAF was observed in 22 patients (4.9%). All cases were observed in patients aged ≥60 years, corresponding to 22 of 164 patients (13.4%). Multiple risk factors were observed, such as age, prior atrial fibrillation, heart failure, hypertension, diabetes mellitus, chronic renal disease, and major (vs. minor) surgery. POAF was associated with severe in-hospital complications (POAF group 45.5% vs. non-POAF group 8.6%, p <.001) and in-hospital mortality (POAF group 13.6% vs. non-POAF group 3.0%, p =.043). In total, 295 patients were monitored by continuous cardiac rhythm monitoring for 12,148 h, yielding five patients with asymptomatic AF. Conclusions: In conclusion, this prospective study of POAF in patients undergoing acute abdominal surgery showed that one in 20 patients developed clinically recognized in-hospital POAF. Multiple risk factors of POAF were identified. POAF was associated with severe complications up to 30 days after surgery.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Acta Anaesthesiologica Scandinavica |
| Vol/bind | 68 |
| Udgave nummer | 3 |
| Sider (fra-til) | 345-353 |
| Antal sider | 9 |
| ISSN | 0001-5172 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:
Continuous cardiac rhythm monitors were purchased from Cortrium, Copenhagen, Denmark. The cardiac rhythm monitors were developed for the Reaching the Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL) study, in which CVM was Investigator and HD was Sponsor. Cortrium and HD were co‐recipients of the grant financing for the REAFEL study. Cortrium did not influence the design, execution, or publication decision of the present study. CSM has co‐founded a start‐up company, WARD247 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD‐project (Wireless Assessment of Respiratory and circulatory Distress, a project developing a clinical support system for continuous wireless monitoring of vital signs). WARD247 ApS has obtained a license agreement for any WARD‐project software and patents. One patent has been filed: “Wireless Assessment of Respiratory and circulatory Distress (WARD) – Clinical Support System (CSS) – an automated clinical support system to improve patient safety and outcomes.” CSM reports direct and indirect departmental research funding from Boehringer Ingelheim and Merck, Sharp & Dohme, and lecture fees from Radiometer. Other researchers declare no affiliation with an entity with a financial or non‐financial interest in the subject matter. No writing assistance was utilized.
Funding Information:
The staff at the Digestive Disease Centre and the Department of Anaesthesia and Intensive Care, Copenhagen University Hospital – Bispebjerg and Frederiksberg, are thanked for contributing to the study. The dedicated medical students are thanked for their valued help acquiring clinical and continuous cardiac rhythm monitoring data. This work was supported by grants from Independent Research Fund Denmark, Novo Nordisk Foundation (NNF18OC0052882), and IMK Almene Fond (30206‐093).
Funding Information:
This work was supported by grants from Independent Research Fund Denmark, Novo Nordisk Foundation (NNF18OC0052882), and IMK Almene Fond (30206‐093).
Publisher Copyright:
© 2023 Acta Anaesthesiologica Scandinavica Foundation.
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