A propensity-matched comparison of the incidence of new-onset postoperative atrial arrhythmias in cardiac and noncardiac thoracic surgery patients

J Cardiothorac Vasc Anesth. 2010 Jun;24(3):447-50. doi: 10.1053/j.jvca.2009.07.006. Epub 2009 Oct 2.

Abstract

Objective: The primary aim of this investigation was to compare the incidence of new-onset postoperative atrial arrhythmias (POAAs) in cardiac versus noncardiac thoracic surgery patients. A subgroup analysis also was performed in the cardiac surgery patients comparing POAAs in patients who underwent cardiac surgery on and off cardiopulmonary bypass (CPB).

Design: This was a retrospective study using the Department of Cardiothoracic Anesthesia patient registry. All patients (n = 33,500) undergoing cardiac (n = 29,057) and noncardiac thoracic (n = 4,443) surgeries between 1993 and 2004 were identified from the patient registry. Two propensity-matched comparisons for the incidence of POAAs were made: (1) in cardiac surgery patients versus noncardiac thoracic surgery patients and (2) in patients undergoing cardiac surgery with versus without CPB.

Setting: A large metropolitan multidisciplinary clinic.

Participants: Patients.

Intervention: No interventions were done because this was a retrospective study.

Measurements and main results: The cardiac patients had a significantly higher incidence of POAAs when compared with noncardiac thoracic surgery patients (11.6% v 7.5%, p < 0.001). There was no significant difference in the incidence of POAAs between patients undergoing CPB versus off-pump CPB (13.3% v 12.3%, p = 0.3).

Conclusion: The incidence of new-onset POAAs was higher in patients undergoing cardiac surgery than in patients undergoing noncardiac thoracic surgery in propensity-matched patient groups. CPB was not associated with new-onset POAAs.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Arrhythmias, Cardiac / epidemiology*
  • Cardiac Surgical Procedures*
  • Cardiopulmonary Bypass
  • Coronary Artery Bypass, Off-Pump
  • Creatinine / blood
  • Databases, Factual
  • Female
  • Heart Atria
  • Heart Rate / physiology
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Sample Size
  • Thoracic Surgical Procedures*

Substances

  • Creatinine