Cardiac Surgery Morbidity and Mortality in Hypertensive and Arrhythmic Patients: A Retrospective Analysis

Cureus. 2023 Nov 8;15(11):e48505. doi: 10.7759/cureus.48505. eCollection 2023 Nov.

Abstract

Background: Hypertension (HTN) is the most significant modifiable risk factor for cardiovascular disease (CVD) and overall mortality. HTN is defined as a systolic blood pressure of ≥140 mmHg and/or a diastolic blood pressure of ≥ 90 mmHg. Generally, arrhythmias are characterized by a disruption of the heart's regular rhythm. They are strongly associated with increased risks of CVDs and sudden death. The most common arrhythmia worldwide is atrial fibrillation (AF). HTN, diabetes mellitus (DM), and coronary artery disease (CAD) are major risk factors for arrhythmias.

Objective: We aimed to identify the postoperative effects and risk factors of HTN and cardiac arrhythmia in patients who underwent cardiac surgery at King Abdulaziz University Hospital (KAUH) from 2015 to 2022.

Methods: A retrospective record review was conducted by collecting data from KAUH electronic medical records. A total of 402 patients participated in this study. This study includes all hypertensive and arrhythmic patients who underwent cardiac surgeries.

Results: Of the 402 patients studied, 209 had pre-operative HTN, and 47 had preoperative AF. Developing post-operative arrhythmia was found to significantly increase perioperative morbidity and mortality (p < 0.001). Risk factors for HTN and arrhythmia included increased age, higher BMI, and DM.

Conclusion: The findings of this study suggest an association between preoperative HTN and AF and elevated rates of postoperative morbidity and mortality. AF emerged as the predominant arrhythmia type. It is advisable to optimize patients' health status prior to surgical procedures. Moreover, further research is recommended in this field to deepen our understanding of the perioperative implications of HTN and arrhythmias.

Keywords: arrhythmias; atrial fibrillation; coronary artery bypass surgery; hypertension; postoperative complications.