The significance of Atrial fibrillation in patients aged ≥55 years undergoing abdominal surgery

Hadiza S. Kazaure, Sanziana A. Roman, Douglas Tyler, Julie A. Sosa

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The Institute of Medicine has identified atrial fibrillation (AF) among national priorities for research. We examine the incidence of AF and its association with outcomes of patients undergoing abdominal surgery. Methods Patients ≥55 years who underwent abdominal surgery captured in a State Inpatient Database, 2008-2010. Three patient groups were created: (1) No diagnosis of AF (No-AF), (2) Pre-existing AF (Hx-AF), and (3) New-onset AF (New-AF). Outcomes were analysed using bivariate and multivariate methods. Results AF incidence among 116,477 patients was 8.6%; approximately one in four patients aged ≥85 years had AF. 26.6% of patients with AF experienced New-AF; the latter was more likely after pancreas resection (43.0%) and least common after cholecystectomy (20.2%). Complications (71.1, 47.3 vs. 26.5%), mortality (8.0, 5.7 vs. 2.0%), longer hospital stays (8.8, 5.6 vs. 3.8 days), and higher hospitalization cost ($41,427, $26,312 vs. $18,310) were more likely in patients with AF (New-AF, Hx-AF vs. No-AF respectively) (all p \ 0.001). After adjustment, New-AF was among factors independently associated with mortality (OR 2.0, 95% CI 1.7-2.4, p < 0.001); each case of New-AF increased cost of care by $4,482. Factors independently associated with New-AF included ≥1 complication, electrolyte imbalance, and procedure-type. Whereas 2.0% of patients who developed New-AF were admitted from a long-term care facility, 23.8% of patients with New-AF were discharged to a long-term care facility. Conclusions AF is common among abdominal surgery patients, particularly the elderly; New-AF is a serious, potentially avoidable adverse event that could serve as an important quality of care indicator for abdominal surgery patients.

Original languageEnglish (US)
Pages (from-to)113-120
Number of pages8
JournalPresentations from the 9th Annual Electric Utilities Environmental Conference
Volume39
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Atrial Fibrillation
Long-Term Care
Costs and Cost Analysis
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Mortality
Quality of Health Care
Incidence
Cholecystectomy
Electrolytes
Inpatients
Pancreas
Length of Stay
Hospitalization
Databases

ASJC Scopus subject areas

  • Surgery

Cite this

The significance of Atrial fibrillation in patients aged ≥55 years undergoing abdominal surgery. / Kazaure, Hadiza S.; Roman, Sanziana A.; Tyler, Douglas; Sosa, Julie A.

In: Presentations from the 9th Annual Electric Utilities Environmental Conference, Vol. 39, No. 1, 01.01.2015, p. 113-120.

Research output: Contribution to journalArticle

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abstract = "Background The Institute of Medicine has identified atrial fibrillation (AF) among national priorities for research. We examine the incidence of AF and its association with outcomes of patients undergoing abdominal surgery. Methods Patients ≥55 years who underwent abdominal surgery captured in a State Inpatient Database, 2008-2010. Three patient groups were created: (1) No diagnosis of AF (No-AF), (2) Pre-existing AF (Hx-AF), and (3) New-onset AF (New-AF). Outcomes were analysed using bivariate and multivariate methods. Results AF incidence among 116,477 patients was 8.6{\%}; approximately one in four patients aged ≥85 years had AF. 26.6{\%} of patients with AF experienced New-AF; the latter was more likely after pancreas resection (43.0{\%}) and least common after cholecystectomy (20.2{\%}). Complications (71.1, 47.3 vs. 26.5{\%}), mortality (8.0, 5.7 vs. 2.0{\%}), longer hospital stays (8.8, 5.6 vs. 3.8 days), and higher hospitalization cost ($41,427, $26,312 vs. $18,310) were more likely in patients with AF (New-AF, Hx-AF vs. No-AF respectively) (all p \ 0.001). After adjustment, New-AF was among factors independently associated with mortality (OR 2.0, 95{\%} CI 1.7-2.4, p < 0.001); each case of New-AF increased cost of care by $4,482. Factors independently associated with New-AF included ≥1 complication, electrolyte imbalance, and procedure-type. Whereas 2.0{\%} of patients who developed New-AF were admitted from a long-term care facility, 23.8{\%} of patients with New-AF were discharged to a long-term care facility. Conclusions AF is common among abdominal surgery patients, particularly the elderly; New-AF is a serious, potentially avoidable adverse event that could serve as an important quality of care indicator for abdominal surgery patients.",
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AB - Background The Institute of Medicine has identified atrial fibrillation (AF) among national priorities for research. We examine the incidence of AF and its association with outcomes of patients undergoing abdominal surgery. Methods Patients ≥55 years who underwent abdominal surgery captured in a State Inpatient Database, 2008-2010. Three patient groups were created: (1) No diagnosis of AF (No-AF), (2) Pre-existing AF (Hx-AF), and (3) New-onset AF (New-AF). Outcomes were analysed using bivariate and multivariate methods. Results AF incidence among 116,477 patients was 8.6%; approximately one in four patients aged ≥85 years had AF. 26.6% of patients with AF experienced New-AF; the latter was more likely after pancreas resection (43.0%) and least common after cholecystectomy (20.2%). Complications (71.1, 47.3 vs. 26.5%), mortality (8.0, 5.7 vs. 2.0%), longer hospital stays (8.8, 5.6 vs. 3.8 days), and higher hospitalization cost ($41,427, $26,312 vs. $18,310) were more likely in patients with AF (New-AF, Hx-AF vs. No-AF respectively) (all p \ 0.001). After adjustment, New-AF was among factors independently associated with mortality (OR 2.0, 95% CI 1.7-2.4, p < 0.001); each case of New-AF increased cost of care by $4,482. Factors independently associated with New-AF included ≥1 complication, electrolyte imbalance, and procedure-type. Whereas 2.0% of patients who developed New-AF were admitted from a long-term care facility, 23.8% of patients with New-AF were discharged to a long-term care facility. Conclusions AF is common among abdominal surgery patients, particularly the elderly; New-AF is a serious, potentially avoidable adverse event that could serve as an important quality of care indicator for abdominal surgery patients.

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