Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
World Journal of Surgery
Published in: World Journal of Surgery 1/2015

01-01-2015 | Original Scientific Report

The Significance of Atrial Fibrillation in Patients Aged ≥55 years Undergoing Abdominal Surgery

Authors: Hadiza S. Kazaure, Sanziana A. Roman, Douglas Tyler, Julie A. Sosa

Published in: World Journal of Surgery | Issue 1/2015

Login to get access

Abstract

Background

The Institute of Medicine has identified atrial fibrillation (AF) among national priorities for research. We examine the incidence of AF and its association with outcomes of patients undergoing abdominal surgery.

Methods

Patients ≥55 years who underwent abdominal surgery captured in a State Inpatient Database, 2008–2010. Three patient groups were created: (1) No diagnosis of AF (No-AF), (2) Pre-existing AF (Hx-AF), and (3) New-onset AF (New-AF). Outcomes were analysed using bivariate and multivariate methods.

Results

AF incidence among 116,477 patients was 8.6 %; approximately one in four patients aged ≥85 years had AF. 26.6 % of patients with AF experienced New-AF; the latter was more likely after pancreas resection (43.0 %) and least common after cholecystectomy (20.2 %). Complications (71.1, 47.3 vs. 26.5 %), mortality (8.0, 5.7 vs. 2.0 %), longer hospital stays (8.8, 5.6 vs. 3.8 days), and higher hospitalization cost ($41,427, $26,312 vs. $18,310) were more likely in patients with AF (New-AF, Hx-AF vs. No-AF respectively) (all p < 0.001). After adjustment, New-AF was among factors independently associated with mortality (OR 2.0, 95 % CI 1.7–2.4, p < 0.001); each case of New-AF increased cost of care by $4,482. Factors independently associated with New-AF included ≥1 complication, electrolyte imbalance, and procedure-type. Whereas 2.0 % of patients who developed New-AF were admitted from a long-term care facility, 23.8 % of patients with New-AF were discharged to a long-term care facility.

Conclusions

AF is common among abdominal surgery patients, particularly the elderly; New-AF is a serious, potentially avoidable adverse event that could serve as an important quality of care indicator for abdominal surgery patients.
Literature
1.
Lloyd-Jones DM, Wang TJ, Leip EP et al (2004) Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation 110(9):1042–1046PubMedCrossRef
2.
Go AS, Hylek EM, Phillips KA et al (2001) Prevalence of diagnosed atrial fibrillation in adults: National implications for rhythm management and stroke prevention: the AnTicoagulation and Risk factors in Atrial Fibrillation (ATRIA) study. JAMA 285(18):2370–2375PubMedCrossRef
3.
Piccini JP, Hammill BG, Sinner MF et al (2012) Incidence and prevalence of atrial fibrillation and associated mortality among medicare beneficiaries: 1993–2007. Circ Cardiovasc Qual Outcomes 5(1):85–93PubMedCentralPubMedCrossRef
4.
Wang TJ, Massaro JM, Levy D et al (2003) Risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: the Framingham Heart Study. JAMA 290(8):1049–1056PubMedCrossRef
5.
Luderitz B, Wang J (2000) Quality of life in patients with atrial fibrillation. Arch Intern Med 160(12):1747–1759CrossRef
6.
7.
Pelletier EM, Hernandez J, Clark MA et al (2005) Medicare costs and health resource utilisation associated with atrial fibrillation in the elderly. J Med Econ 8(1–4):55–65CrossRef
8.
Lee WC, Lamas GA, Balu S et al (2008) Direct treatment cost of atrial fibrillation in the elderly American population: a Medicare perspective. J Med Econ 11(2):281–298PubMed
9.
10.
11.
Al Sarraf N, Thalib L, Hughes A et al (2012) Effect of preoperative atrial fibrillation on postoperative outcome following cardiac surgery. Cardiol Res Pract 2012:272384PubMedCentralPubMed
12.
Arsenault KA, Yusuf AM, Crystal E, et al. (2013) Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery. Cochrane Database of Syst Rev. (1). CD003611
13.
Kaireviciute D, Aidietis A, Lip GYH (2009) Atrial fibrillation following cardiac surgery: clinical features and preventative strategies. Eur Heart J 30(4):410–425PubMedCrossRef
14.
Brathwaite D, Weissman C (1998) The new onset of atrial arrhythmias following major non cardiothoracic surgery is associated with increased mortality. Chest 114(2):462–468PubMedCrossRef
15.
Bhave PD, Goldman LE, Vittinghoff E et al (2012) Incidence, predictors, and outcomes associated with postoperative atrial fibrillation after major noncardiac surgery. Am Heart J 164(6):918–924PubMedCentralPubMedCrossRef
16.
Christians KK, Wu B, Quebbeman EJ et al (2001) Postoperative atrial fibrillation in non cardiothoracic surgical patients. Am J Surg 182(6):713–715PubMedCrossRef
17.
18.
Walkey AJ, Wiener RS, Ghobrial JM et al (2011) Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis. JAMA 306:2248–2254PubMedCentralPubMedCrossRef
19.
Glazer NL, Dublin S, Smith NL et al (2007) Newly detected atrial fibrillation and compliance with antithrombotic guidelines. Arch Intern Med 167(3):246–252PubMedCrossRef
20.
Quan H, Sundararajan V, Halfon P et al (2005) Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 43(11):1130–1139PubMedCrossRef
21.
Ghaferi AA, Birkmeyer JD, Dimick JB (2009) Variation in hospital mortality associated with inpatient surgery. N Engl J Med 361(14):1368–1375PubMedCrossRef
22.
Iezzoni LI, Davis RB, Palmer RH et al (1999) Does the Complications Screening Program flag cases with process of care problems? Using explicit criteria to judge processes. Int J Qual Health Care 11(2):107–118PubMedCrossRef
23.
Weingart SN, Iezzoni LI, Davis RB et al (2000) Use of administrative data to find substandard care: validation of the complications screening program. Med Care 38(8):796–806PubMedCrossRef
24.
25.
Tsang TS, Gersh BJ (2002) Atrial fibrillation: an old disease, a new epidemic. Am J Med 113(5):432–435PubMedCrossRef
26.
Elixhauser A, Andrews RM (2010) Profile of inpatient operating room procedures in US hospitals in 2007. Arch Surg 145(12):1201–1208PubMedCrossRef
27.
Wyse DG, Gersh BJ (2004) Atrial fibrillation: a perspective: thinking inside and outside the box. Circulation 109:3089–3095PubMedCrossRef
28.
Burgess DC, Kilborn MJ, Keech AC (2006) Interventions for prevention of post-operative atrial fibrillation and its complications after cardiac surgery: a meta-analysis. Eur Heart J 27(23):2846–2857PubMedCrossRef
29.
Stewart S, Hart CL, Hole DJ et al (2002) A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study. Am J Med 113(5):359–364PubMedCrossRef
30.
Benjamin EJ, Wolf PA, D’Agostino RB et al (1998) Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation 98(10):946–952PubMedCrossRef
31.
Mayson SE, Greenspon AJ, Adams S et al (2007) The changing face of postoperative atrial fibrillation prevention: a review of current medical therapy. Cardiol Rev 15(5):231–241PubMedCrossRef
32.
33.
34.
Bhave PD, Kamel H (2013) New onset of atrial fibrillation in the hospitalized patient. J Hosp Med 8(3):154–158PubMedCrossRef
35.
Mathew J, Fontes M, Tudor I et al (2004) A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA 291(14):1720–1729PubMedCrossRef
Metadata
Title
The Significance of Atrial Fibrillation in Patients Aged ≥55 years Undergoing Abdominal Surgery
Authors
Hadiza S. Kazaure
Sanziana A. Roman
Douglas Tyler
Julie A. Sosa
Publication date
01-01-2015
Publisher
Springer US
Published in
World Journal of Surgery / Issue 1/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2777-7

Other articles of this Issue 1/2015

World Journal of Surgery 1/2015 Go to the issue

EditorialNotes

Comparison of Two Models of Surgical Care for Patients with Clefts in Peru

Original Scientific Report

Risk Factors and Preventive Measures for Acute Urinary Retention after Rectal Cancer Surgery

Original Scientific Report

A Meta-analysis of the Predictive Accuracy of Postoperative Mortality Using the American Society of Anesthesiologists’ Physical Status Classification System

OriginalPaper

Prevalence of Surgical Conditions in Individuals Aged More Than 50 Years: A Cluster-Based Household Survey in Sierra Leone

Original Scientific Report

Using a Hybrid Electronic Medical Record System for the Surveillance of Adverse Surgical Events and Human Error in A Developing World Surgical Service

Original Scientific Report

Intraoperative Frozen Section for the Evaluation of Extrathyroidal Extension in Papillary Thyroid Cancer