Predictors and mortality of new onset postoperative atrial fibrillation after STAAD surgery: a retrospective cohort study

Abstract

Background: Data on new onset postoperative atrial fibrillation (POAF) after Stanford type A dissection (STAAD) surgery was limited. This study aimed to detect the risk factors for developing POAF after STAAD procedures and the association between POAF and in-hospital mortality. Methods: A total of 1354 patients who underwent surgical treatment for STAAD in our center were enrolled in this single-center retrospective study from January 2015 to October 2020. POAF were defined as atrial fibrillation/flutter requiring treatment after surgery procedure. Logistic model was conducted to detect the predictors of POAF, and inverse probability of treatment weighting (IPTW) and subgroup analysis were used to compare the mortality of POAF and non-POAF groups. Results: There were 176 patients (13.0%) diagnosed with POAF according to the definition. Multivariate logistics analyses revealed that advanced age (odds ratio [OR], 1.07; 95%CI, 1.05–1.08; P<0.001), creatinine (OR, 1.00; 95%CI, 1.00–1.01; P=0.001) and cross-clamp time (OR, 1.00; 95%CI, 1.00–1.01; P=0.021) were independent risk factors of developing POAF in STAAD patients. POAF patients were associated with significantly higher in-hospital mortality compared with non-POAF patients (6.5% vs. 19.9%, OR, 3.60; 95%CI, 2.30–5.54; P<0.001), IPTW and subgroup analysis had reached consistent conclusions. Conclusions: The incidence of POAF was 13.0% after STAAD surgery, advanced age, creatinine and cross-clamp time were independent risk factors of developing POAF in STAAD patients. POAF is associated with increased mortality after STAAD procedures.