Post-Operative New-Onset Onset Atrial Fibrillation in Non-Cardiac Operations Prevalence, Recurrent Rate and Long-Term MACE (POAF-NCS Study)

Abstract

Post-operative new-onset atrial fibrillation (POAF) is a common complication after cardiothoracic surgery but not much has been studied about its occurrence in a non-cardiothoracic surgery. This study was conducted to examine the risk factors for the appearance of POAF, treatment strategy and onset of abnormal cardiovascular events (MACE) in the short and long term.

Methodology

This is a retrospective cohort study that was conducted in Emek medical center, Afula, Israel. The study population consists of patients hospitalized in five surgical wards from January 1, 2014 to the end of December 2017. Patients who met the inclusion criteria were divided based on the appearance of POAF.

Results

A total of 30,223 operations were performed at 5 surgical wards during the study period. About two-fifth (40%) were operated electively and the rest of the participants underwent emergency surgery. The mean age was 63.78 ± 11.50 and more than two-thirds (67.1%) of the participants were males. The prevalence of POAF vary significantly, with the highest prevalence of 0.22% observed among orthopedics and general surgery operation. Laparotomy and Hip fixation surgeries had the highest prevalence of AF. Average length of hospitalization (LOH) was significant higher in POAF patients (24 vs 4.4 days, p<.001) and was correlates with CHADS2-VASC score. Patient who develop POAF had higher rate of all-cause mortality at 1 year was which was correlate which CHADS2-VASc Score. There was no significant association between occurrence of MACE and treatment modalities like rate/rhythm control drug and anticoagulant use.

Conclusion:

New onset AF following non cardiac surgery is rare, yet, pose a significant clinical and outcome implication. POAF is associates with longer hospitalization length, multiple drug use and high rate of 1-year mortality.