Bae SJ, Kwon CH, Kim TY, Chang H, Kim BS, Kim SH, Kim HJ. Predictors and prognostic impact of post-operative atrial fibrillation in patients with hip fracture surgery. World J Clin Cases 2022; 10(11): 3379-3388 [PMID: 35611197 DOI: 10.12998/wjcc.v10.i11.3379]
Corresponding Author of This Article
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
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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World J Clin Cases. Apr 16, 2022; 10(11): 3379-3388 Published online Apr 16, 2022. doi: 10.12998/wjcc.v10.i11.3379
Table 1 Baseline characteristics of study patients according to occurrence of post-operative atrial fibrillation
Variables
Sinus rhythm (n = 225)
POAF (n = 20)
P value
Age (yr)
75.3 ± 13.3
84.3 ± 5.7
< 0.001
Male
79 (35.1)
7 (35.0)
0.992
Medical history
Hypertension
153 (68.0)
14 (70.0)
0.854
Diabetes
68 (30.2)
5 (25.0)
0.625
Chronic kidney disease
30 (13.3)
5 (25.0)
0.153
Coronary artery disease
15 (6.7)
3 (15.0)
0.171
Previous MI
6 (2.7)
3 (15.0)
0.005
Previous CHF
9 (4.0)
3 (15.0)
0.029
Previous stroke
27 (12.0)
1 (5.0)
0.346
COPD
14 (6.2)
6 (30.0)
< 0.001
Echocardiographic parameter
LVEF, %
59.1 ± 6.9
56.3 ± 9.2
0.096
LVEF < 50%
18 (8.0)
2 (10.0)
0.754
E/e’
10.9 ± 3.2
12.6 ± 2.8
0.047
Laboratory parameter
Hemoglobin, g/dL
11.8 ± 2.0
11.2 ± 2.1
0.227
Creatinine, mg/dL
1.0 ± 1.1
1.2 ± 0.8
0.634
CK-MB, ng/mL
2.9 ± 3.9
2.8 ± 4.3
0.863
hsTn-I, ng/L
30.3 ± 155.2
24.1 ± 29.1
0.858
NT-proBNP, pg/dL
598.8 ± 1923.4
1172.7 ± 1844.5
0.251
Table 2 Independent predictors of post-operative atrial fibrillation following hip fracture surgery
Variables
Unadjusted OR (95%CI)
P value
Adjusted OR (95%CI)
P value
Age (yr)
1.100 (1.031-1.172)
0.004
1.111 (1.022-1.209)
0.014
Male
0.995 (0.382-2.596)
0.992
Hypertension
1.098 (0.405-2.974)
0.854
Diabetes mellitus
0.770 (0.269-2.202)
0.625
Chronic kidney disease
2.167 (0.734-6.397)
0.162
Coronary artery disease
0.405 (0.107-1.537)
0.184
Previous MI
6.441 (1.479-28.046)
0.013
Previous CHF
4.235 (1.048-17.120)
0.043
Previous stroke
0.386 (0.050-3.000)
0.363
COPD
6.459 (2.153-19.380)
0.001
6.352 (1.561-25.841)
0.010
LVEF (%)
0.952 (0.899-1.009)
0.098
E/e’
1.151 (0.999-1.327)
0.051
1.174 (1.002-1.376)
0.047
Hemoglobin (g/dL)
0.870 (0.694-1.091)
0.228
Creatinine (mg/dL)
1.083 (0.778-1.506)
0.636
CK-MB (ng/mL)
0.988 (0.872-1.120)
0.853
hsTn-I (ng/L)
1.000 (0.996-1.003)
0.859
NT-proBNP (pg/dL)
1.000 (1.000-1.000)
0.279
Table 3 Clinical adverse events during hospitalization according to occurrence of post-operative atrial fibrillation
Sinus rhythm (n = 225)
POAF (n = 20)
P value
Transfusion
190 (84.4)
19 (95.0)
0.201
Transfused packed RBC count
3.4 ± 4.4
4.1 ± 2.4
0.508
Admission day
23.0 ± 33.8
29.6 ± 18.4
0.391
Intensive care unit admission
33 (14.7)
11 (55.0)
< 0.001
Congestive heart failure
24 (10.7)
9 (45.0)
< 0.001
Pulmonary thromboembolism
4 (1.8)
0 (0.0)
0.548
Acute coronary syndrome
7 (3.1)
2 (10.0)
0.117
Death
3 (1.3)
0 (0.0)
0.548
Table 4 Independent predictors of incident congestive heart failure following hip fracture surgery
Variables
Unadjusted OR (95%CI)
P value
Adjusted OR (95%CI)
P value
Age (yr)
1.060 (1.015-1.107)
0.008
Male
1.238 (0.583-2.629)
0.579
Hypertension
0.924 (0.424-2.015)
0.843
Diabetes mellitus
0.724 (0.310-1.690)
0.455
Chronic kidney disease
3.917 (1.692-9.066)
0.001
2.570 (0.946-6.980)
0.064
Coronary artery disease
1.951 (0.601-6.333)
0.266
Previous MI
5.710 (1.450-22.495)
0.013
Previous CHF
5.230 (1.554-17.602)
0.008
Previous stroke
1.080 (0.350-3.339)
0.893
COPD
5.333 (1.989-14.303)
0.001
3.408 (0.898-12.934)
0.072
LVEF (%)
0.971 (0.925-1.020)
0.243
E/e’
1.088 (0.967-1.224)
0.159
Hemoglobin (g/dL)
0.688 (0.565-0.838)
< 0.001
0.753 (0.597-0.949)
0.016
Creatinine (mg/dL)
1.266 (0.997-1.608)
0.053
CK-MB (ng/mL)
1.042 (0.969-1.121)
0.268
hsTn-I (ng/L)
1.001 (0.999-1.003)
0.334
NT-proBNP (pg/dL)
1.000 (1.000-1.000)
0.050
Post-operative AF
6.852 (2.579-18.209)
< 0.001
4.856 (1.437-16.411)
0.011
Table 5 Independent predictors of intensive care unit admission following hip fracture surgery
Variables
Unadjusted OR (95%CI)
P value
Adjusted OR (95%CI)
P value
Age (yr)
1.017 (0.989-1.046)
0.242
Male
0.836 (0.417-1.678)
0.615
Hypertension
0.781 (0.394-1.546)
0.477
Diabetes mellitus
1.444 (0.727-2.868)
0.295
Chronic kidney disease
2.458 (1.100-5.496)
0.028
Coronary artery disease
1.336 (0.418-4.271)
0.626
Previous MI
2.378 (0.571-9.900)
0.234
Previous CHF
5.132 (1.571-16.763)
0.007
3.295 (0.860-12.632)
0.082
Previous stroke
2.463 (1.030-5.889)
0.043
3.718 (1.326-10.420)
0.013
COPD
2.109 (0.762-5.837)
0.151
LVEF (%)
0.979 (0.937-1.024)
0.358
E/e’
1.032 (0.928-1.148)
0.557
Hemoglobin (g/dL)
0.853 (0.724-1.004)
0.057
Creatinine (mg/dL)
1.348 (1.054-1.725)
0.018
1.416 (1.085-1.848)
0.011
CK-MB (ng/mL)
1.033 (0.963-1.108)
0.368
hsTn-I (ng/L)
1.002 (1.000-1.004)
0.112
NT-proBNP (pg/dL)
1.000 (1.000-1.000)
0.019
Post-operative AF
7.111 (2.736-18.484)
<0.001
6.615 (2.112-20.718)
0.001
Citation: Bae SJ, Kwon CH, Kim TY, Chang H, Kim BS, Kim SH, Kim HJ. Predictors and prognostic impact of post-operative atrial fibrillation in patients with hip fracture surgery. World J Clin Cases 2022; 10(11): 3379-3388