The predictive value of new-onset atrial fibrillation on postoperative morbidity after esophagectomy

Autor: M F J Seesing, R. van Hillegersberg, J C G Scheijmans, Alicia S Borggreve, Jelle P. Ruurda
Přispěvatelé: Graduate School
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Esophageal Neoplasms
medicine.medical_treatment
Anastomotic Leak
030230 surgery
Risk Assessment
Esophageal Neoplasms/surgery
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Esophagectomy/adverse effects
Predictive Value of Tests
Risk Assessment/statistics & numerical data
Risk Factors
Atrial Fibrillation
Medicine
Humans
Prospective Studies
Prospective cohort study
Adverse effect
Aged
Retrospective Studies
Pneumonia/etiology
business.industry
Medical record
Gastroenterology
Retrospective cohort study
Atrial fibrillation
Pneumonia
General Medicine
Esophageal cancer
Middle Aged
medicine.disease
Surgery
Esophagectomy
Atrial Fibrillation/etiology
030220 oncology & carcinogenesis
Predictive value of tests
Multivariate Analysis
Female
Postoperative Complications/etiology
business
Anastomotic Leak/etiology
Zdroj: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 31(11). Wiley-Blackwell
ISSN: 1120-8694
DOI: 10.1093/dote/doy028
Popis: New-onset atrial fibrillation (AF) is frequently observed following esophagectomy and may predict other complications. The aim of the current study was to determine the association between, and the possible predictive value of, new-onset AF and infectious complications following esophagectomy. Consecutive patients who underwent elective esophagectomy with curative intent for esophageal cancer between 2004 and 2016 in the University Medical Center Utrecht were included from a prospective database. The date of diagnosis of the complications included in the current analysis was retrospectively collected from the computerized medical record. The association between new-onset AF and infectious complications was studied in univariable and multivariable logistic regression analyses. A total of 455 patients were included. In 93 (20.4%) patients new-onset AF was encountered after esophagectomy. There were no significant differences in patient and treatment-related characteristics between the patients with and without AF. In 9 (9.7%) patients, AF was the only adverse event following surgery. In multivariable analyses, AF was significantly associated with infectious complications in general (OR 3.00, 95% CI: 1.73-5.21). More specifically, AF was associated with pulmonary complications (OR 2.06, 95% CI: 1.29-3.30), pneumonia (OR 2.41, 95% CI: 1.48-3.91) and anastomotic leakage (OR 3.00, 95% CI: 1.80-4.99). In patients who underwent esophagectomy, new-onset AF was highly associated with infectious complications. AF may serve as an early clinical warning sign for anastomotic leakage. Therefore, further evaluation of patients who develop new-onset AF after esophagectomy is warranted.
Databáze: OpenAIRE
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