Postoperative Atrial Fibrillation in Lung Cancer Lobectomy—Analysis of Risk Factors and Prognosis

• Published in: World journal of surgery Vol. 44; no. 11; pp. 3952 - 3959
• Main Authors: Ishibashi, Hironori, Wakejima, Ryo, Asakawa, Ayaka, Baba, Shunichi, Nakashima, Yasuhiro, Seto, Katsutoshi, Kobayashi, Masashi, Okubo, Kenichi
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.11.2020; Springer Nature B.V
• Subjects: Abdominal Surgery; Blood transfusion; Blood transfusions; Cardiac arrhythmia; Cardiac Surgery; Chronic obstructive pulmonary disease; Complications; Diabetes mellitus; Fibrillation; General Surgery; Health risks; Lung cancer; Lung diseases; Medical prognosis; Medicine; Medicine & Public Health; Multivariate analysis; Obstructive lung disease; Original Scientific Report; Postoperative period; Prognosis; Risk analysis; Risk factors; Surgery; Survival; Thoracic Surgery; Transfusion; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-020-05694-w

Background The incidence of postoperative atrial fibrillation (POAF) after pulmonary lobectomy ranges from 6.4 to 12.6%. This study aimed to analyze the postoperative risk factors and prognosis for POAF in lobectomy for lung cancer. Methods Data were collected from patients undergoing pulmonary lobectomy from April 2010 to March 2019. We analyzed risk factors for POAF among perioperative factors and compared postoperative complications or overall survival between POAF and non-POAF groups. We classified POAF as either the temporary or non-temporary type and compared perioperative factors, postoperative complications, and overall survival. Results POAF was identified in 49 (5.2%) of the 947 lobectomies. The POAF group included more males, patients with poor performance status (PS), history of paroxysmal atrial fibrillation (AF), chronic obstructive pulmonary disease (COPD), and intraoperative blood transfusions. Poor PS, COPD, previous paroxysmal AF, and intraoperative blood transfusion were independent risk factors for POAF in multivariate analysis. The POAF group had a poorer prognosis than the non-POAF group ( p  = 0.0045). POAF was divided into 29 temporary and 20 non-temporary types. The onset date of non-temporary-type POAF was significantly later than that of the transient type ( P  < 0.01), and diabetes mellitus was significantly higher in non-temporary-type POAF. Non-temporary-type POAF had a significantly poorer prognosis in terms of overall survival ( p  = 0.005). Conclusions Poor PS, COPD, history of PAF, and intraoperative blood transfusion were independent risk factors for POAF. Non-temporary-type POAF occurred significantly later than transient type and caused poorer prognosis after lobectomy for lung cancer.