Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2022; 10(11): 3379-3388
Published online Apr 16, 2022. doi: 10.12998/wjcc.v10.i11.3379
Predictors and prognostic impact of post-operative atrial fibrillation in patients with hip fracture surgery
Seong Jun Bae, Chang Hee Kwon, Tae-Young Kim, Haseong Chang, Bum Sung Kim, Sung Hea Kim, Hyun-Joong Kim
Seong Jun Bae, Chang Hee Kwon, Haseong Chang, Bum Sung Kim, Sung Hea Kim, Hyun-Joong Kim, Department of Internal Medicine, Konkuk University Medical Center, Seoul 05030, South Korea
Tae-Young Kim, Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul 05030, South Korea
Author contributions: Kwon CH conceptioned and designed the research study; Bae SJ acquisitioned the data; Bae SJ and Kwon CH analysised and interpreted the data; Bae SJ and Kwon CH prepared the manuscript; Kwon CH, Bae SJ, Kim TY, Chang H, Kim BS, Kim SH, and Kim HJ revised the manuscript.
Institutional review board statement: The present study protocol was reviewed and approved by the Institutional Review Board of the Konkuk University Medical Center (protocol No. KUMC 2019-07-053). The requirement for informed consent was waived because de-identified information was retrieved retrospectively.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chang Hee Kwon, MD, PhD, Assistant Professor, Internal Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, South Korea. vertex_77@naver.com
Received: October 15, 2021
Peer-review started: October 15, 2021
First decision: December 17, 2021
Revised: December 18, 2021
Accepted: February 17, 2022
Article in press: February 27, 2022
Published online: April 16, 2022
Processing time: 175 Days and 8.4 Hours
Abstract
BACKGROUND

Atrial fibrillation (AF) is the most common arrhythmia developing in post-operative patients. Limited data are available regarding pre-operative risk factors and prognostic impact of post-operative AF (POAF) following hip fracture surgery (HFS) in Korean population.

AIM

We aimed to investigate the incidence, predictors, and hospital prognosis of POAF in HFS patients.

METHODS

This study included 245 patients without history of AF who underwent HFS between August 2014 and November 2016. POAF was defined as new-onset AF that occurred during hospitalization after HFS.

RESULTS

Twenty patients (8.2%) experienced POAF after HFS. POAF developed on median post-operative day 2 (interquartile range, 1–3). Multivariable logistic regression analysis showed that age [odds ratio (OR), 1.111; 95% confidence interval (CI), 1.022–1.209], chronic obstructive pulmonary disease (COPD) (OR, 6.352; 95%CI, 1.561–25.841) and E/e’ ratio (OR, 1.174; 95%CI, 1.002–1.376) were significant predictors of POAF. Patients with POAF had a significantly higher intensive care unit admission rate (55.0% vs 14.7%, P < 0.001) and incidence of congestive heart failure (45.0% vs 10.7%, P < 0.001). In multivariable logistic regression analysis, POAF was significantly associated with increased incidence of congestive heart failure (OR, 4.856; 95%CI, 1.437–16.411) and intensive care unit admission (OR, 6.615; 95%CI, 2.112–20.718).

CONCLUSION

POAF was frequently developed in elderly patients following HFS. Age, COPD and elevated E/e’ ratio were found as significant predictors of POAF in HFS patients. Patients with POAF significantly experienced intensive care unit admission and incident congestive heart failure during hospitalization.

Keywords: Atrial fibrillation; Post-operative; Predictor; Prognosis; Hip fracture surgery

Core Tip: This study is a retrospective study to evaluate the predictors and prognosis of post-operative atrial fibrillation (POAF) following hip fracture surgery (HFS) in elderly patients. Atrial fibrillation (AF) was developed in 8.2% following HFS. Patients with older age, COPD, or elevated E/e’ ratio were shown as high risk of suffering POAF following HFS. Moreover, Patients with POAF significantly experienced intensive care unit admission and incident heart failure rather than those without POAF. Therefore, physicians have to carefully observe the occurrence of AF after HFS in elderly patients.