Diltiazem Does Not Prevent Postoperative Atrial Fibrillation After Thoracoscopic Lobectomy
| Autor: | Alexa Deemer, Franzes Anne Liongson, Nicholas Roma, Madeline R Lederer, Jill Stoltzfus, Charles T. Lee, William R. Burfeind |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry medicine.medical_treatment Atrial fibrillation General Medicine medicine.disease Stroke Diltiazem Postoperative Complications Risk Factors Internal medicine Atrial Fibrillation Cardiology Medicine Humans Surgery Thoracotomy Cardiology and Cardiovascular Medicine business Adverse effect medicine.drug Aged Retrospective Studies |
| Zdroj: | Innovations (Philadelphia, Pa.). 16(3) |
| ISSN: | 1559-0879 |
| Popis: | ObjectiveThoracoscopic lobectomy is associated with lower rates of adverse events compared to thoracotomy. Despite this, postoperative atrial fibrillation (POAF) occurs in at least 10% of patients. Our objective is to determine if prophylaxis with diltiazem significantly reduced POAF events.MethodsPatients without prior history of atrial fibrillation who underwent thoracoscopic lobectomy from 2007 to 2016 at one institution were analyzed in a retrospective cohort study utilizing a prospective database. Patients treated from 2007 to 2012 received no prophylaxis. Patients treated after 2012 received diltiazem postoperatively. All patients were monitored with continuous telemetry postoperatively. Multivariate direct logistic regression was performed to determine independent predictors of POAF. We report adjusted odds ratios and accompanying 95% confidence intervals, with P < 0.05 denoting statistical significance.ResultsThe final regression model included 416 patients (52 with POAF, 364 without). In univariate analysis, the variables of body mass index and history of congestive heart failure, diabetes, or hypertension, and prophylaxis status did not meet inclusion criteria. Age, gender, history of stroke or transient ischemic attack, and vascular disease were included. Only ages 65 to 74 ( P = 0.03) and ≥75 ( P = 0.02), compared to ConclusionsDiltiazem prophylaxis did not significantly reduce POAF incidence following thoracoscopic lobectomy. Further study is warranted since POAF remains an unwanted source of morbidity and cost for lobectomy patients. |
| Databáze: | OpenAIRE |
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