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Article: Atrial fibrillation after esophagectomy is a marker for postoperative morbidity and mortality

TitleAtrial fibrillation after esophagectomy is a marker for postoperative morbidity and mortality
Authors
Issue Date2003
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jtcvs
Citation
Journal Of Thoracic And Cardiovascular Surgery, 2003, v. 126 n. 4, p. 1162-1167 How to Cite?
AbstractObjective: Postoperative atrial fibrillation complicates recovery in 20% to 25% of patients after esophagectomy for cancer. The purpose of this study is to understand this phenomenon. Methods: Between 1982 and 2000, 198 (22% of 921) patients had postoperative atrial fibrillation after esophagectomy. Propensity scoring and the Greedy Match algorithm were used to develop a cohort of control patients for statistical comparisons. One hundred forty-four patients who had postoperative atrial fibrillation were matched. Results: Pulmonary complications affected 42% of patients in the atrial fibrillation group compared with 17% in the control group (P < .001). Anastomotic leakage was more common in the atrial fibrillation group (6.9% vs 1.4%, P = .035). Surgical sepsis migrated with atrial fibrillation 4 times more frequently (P = .001). Multivariate analysis demonstrated that postoperative pulmonary complications (odds ratio, 2.5; 95% confidence interval, 1.42-4.3) and surgical sepsis (odds ratio, 3.4; 95% confidence interval, 1.2-9.6) were associated with postoperative atrial fibrillation. The mortality rates of the atrial fibrillation and control groups were 23% and 3%, respectively (P < .001). Median survival, excluding hospital deaths, was not different at 14.5 months (atrial fibrillation group) and 16.9 months (control group; = .4). Conclusion: Atrial fibrillation is a surrogate for surgical morbidity and mortality after esophagectomy. The occurrence of atrial fibrillation after esophageal resection should prompt not only the appropriate management of the arrhythmia but also a search for a more ominous underlying cause.
Persistent Identifierhttp://hdl.handle.net/10722/83776
ISSN
2015 Impact Factor: 3.494
2015 SCImago Journal Rankings: 2.369
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMurthy, SCen_HK
dc.contributor.authorLaw, Sen_HK
dc.contributor.authorWhooley, BPen_HK
dc.contributor.authorAlexandrou, Aen_HK
dc.contributor.authorChu, KMen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:45:04Z-
dc.date.available2010-09-06T08:45:04Z-
dc.date.issued2003en_HK
dc.identifier.citationJournal Of Thoracic And Cardiovascular Surgery, 2003, v. 126 n. 4, p. 1162-1167en_HK
dc.identifier.issn0022-5223en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83776-
dc.description.abstractObjective: Postoperative atrial fibrillation complicates recovery in 20% to 25% of patients after esophagectomy for cancer. The purpose of this study is to understand this phenomenon. Methods: Between 1982 and 2000, 198 (22% of 921) patients had postoperative atrial fibrillation after esophagectomy. Propensity scoring and the Greedy Match algorithm were used to develop a cohort of control patients for statistical comparisons. One hundred forty-four patients who had postoperative atrial fibrillation were matched. Results: Pulmonary complications affected 42% of patients in the atrial fibrillation group compared with 17% in the control group (P < .001). Anastomotic leakage was more common in the atrial fibrillation group (6.9% vs 1.4%, P = .035). Surgical sepsis migrated with atrial fibrillation 4 times more frequently (P = .001). Multivariate analysis demonstrated that postoperative pulmonary complications (odds ratio, 2.5; 95% confidence interval, 1.42-4.3) and surgical sepsis (odds ratio, 3.4; 95% confidence interval, 1.2-9.6) were associated with postoperative atrial fibrillation. The mortality rates of the atrial fibrillation and control groups were 23% and 3%, respectively (P < .001). Median survival, excluding hospital deaths, was not different at 14.5 months (atrial fibrillation group) and 16.9 months (control group; = .4). Conclusion: Atrial fibrillation is a surrogate for surgical morbidity and mortality after esophagectomy. The occurrence of atrial fibrillation after esophageal resection should prompt not only the appropriate management of the arrhythmia but also a search for a more ominous underlying cause.en_HK
dc.languageengen_HK
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jtcvsen_HK
dc.relation.ispartofJournal of Thoracic and Cardiovascular Surgeryen_HK
dc.rightsThe Journal of Thoracic and Cardiovascular Surgery. Copyright © Mosby, Inc.en_HK
dc.titleAtrial fibrillation after esophagectomy is a marker for postoperative morbidity and mortalityen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0022-5223&volume=126&issue=4&spage=1162&epage=1167&date=2003&atitle=Atrial+fibrillation+after+esophagectomy+is+a+marker+for+postoperative+morbidity+and+mortalityen_HK
dc.identifier.emailLaw, S: slaw@hku.hken_HK
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLaw, S=rp00437en_HK
dc.identifier.authorityChu, KM=rp00435en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0022-5223(03)00974-7en_HK
dc.identifier.pmid14566263-
dc.identifier.scopuseid_2-s2.0-0142213822en_HK
dc.identifier.hkuros85254en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0142213822&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume126en_HK
dc.identifier.issue4en_HK
dc.identifier.spage1162en_HK
dc.identifier.epage1167en_HK
dc.identifier.isiWOS:000186095400040-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridMurthy, SC=7202013138en_HK
dc.identifier.scopusauthoridLaw, S=7202241293en_HK
dc.identifier.scopusauthoridWhooley, BP=6602989930en_HK
dc.identifier.scopusauthoridAlexandrou, A=12760653800en_HK
dc.identifier.scopusauthoridChu, KM=7402453538en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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