New onset postoperative atrial fibrillation predicts long-term cardiovascular events after gastrectomy

Sean P Nassoiy; Robert H Blackwell; Anai N Kothari; Stephanie Besser; Gopal N Gupta; Paul C Kuo; Gerard J Abood

doi:10.1016/j.amjsurg.2015.10.024

New onset postoperative atrial fibrillation predicts long-term cardiovascular events after gastrectomy

Am J Surg. 2016 Mar;211(3):559-64. doi: 10.1016/j.amjsurg.2015.10.024. Epub 2015 Dec 21.

Authors

Sean P Nassoiy¹, Robert H Blackwell², Anai N Kothari³, Stephanie Besser⁴, Gopal N Gupta⁵, Paul C Kuo⁶, Gerard J Abood⁷

Affiliations

¹ Department of Surgery, Loyola University Medical Center, Maywood, IL, USA.
² 1:MAP Surgical Analytics Group, Loyola University Medical Center, Maywood, IL, USA.
³ Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; 1:MAP Surgical Analytics Group, Loyola University Medical Center, Maywood, IL, USA.
⁴ 1:MAP Surgical Analytics Group, Loyola University Medical Center, Maywood, IL, USA; Department of Public Health Sciences, Loyola University Medical Center, Maywood, IL, USA.
⁵ 1:MAP Surgical Analytics Group, Loyola University Medical Center, Maywood, IL, USA; Stritch School of Medicine, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA.
⁶ Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; 1:MAP Surgical Analytics Group, Loyola University Medical Center, Maywood, IL, USA; Stritch School of Medicine, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA.
⁷ Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; 1:MAP Surgical Analytics Group, Loyola University Medical Center, Maywood, IL, USA; Stritch School of Medicine, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA. Electronic address: gabood@lumc.edu.

Abstract

Background: Recent evidence suggests transient postoperative atrial fibrillation leads to future cardiovascular events, even in noncardiac surgery. The long-term effects of postoperative atrial fibrillation in gastrectomy patients are unknown.

Methods: The Healthcare Cost and Utilization Project State Inpatient Databases identified patients undergoing gastrectomy for malignancy between 2007 and 2010. Patients were matched by propensity scores based on various factors. Adjusted Kaplan-Meier and Cox proportional hazards models assessed the effect of postoperative atrial fibrillation on cardiovascular events.

Results: A higher incidence of cardiovascular events occurred over the 1st year in patients who developed postoperative atrial fibrillation. Cox proportional hazards regression confirmed an increased risk of cardiovascular events in postoperative atrial fibrillation patients.

Conclusions: Our results demonstrate that patients undergoing gastrectomy for malignancy who develop postoperative atrial fibrillation are at increased risk of cardiovascular events within 1 year. Physicians should be vigilant in assessing postoperative atrial fibrillation, given the increased risk of cardiovascular morbidity.

Keywords: Atrial fibrillation; Gastrectomy; Myocardial infarction; Postoperative complications; Stroke.

MeSH terms

Aged
Atrial Fibrillation / epidemiology*
California / epidemiology
Comorbidity
Female
Florida / epidemiology
Gastrectomy*
Humans
Incidence
Kaplan-Meier Estimate
Male
Postoperative Complications / epidemiology*
Proportional Hazards Models
Risk Factors
Stomach Neoplasms / surgery*

Grants and funding

T32 GM008750/GM/NIGMS NIH HHS/United States