• Author
    Kahtrel Maynard
  • Discovery PI

    Matthew A. Fischer, MD, MS

  • Project Co-Author

  • Abstract Title

    A Single Center Retrospective Analysis of Postoperative Atrial Fibrillation in Lung Transplant Recipients 

  • Discovery AOC Petal or Dual Degree Program

    Healthcare Improvement & Health Equity Research

  • Abstract

    Background: 

    Postoperative atrial fibrillation (POAF) is associated with increased hospital costs, prolonged intensive care unit stays, and higher 30-day readmission rates. While POAF occurs frequently following lung transplantation, specific risk factors in this population remain poorly characterized. This may be partially attributable to inconsistent definitions of POAF and inclusion of other atrial arrhythmias in POAF cohorts, which confound results.  

     

    Objective: 

    We aimed to determine the incidence of isolated POAF in this population and identify risk factors within a large cohort. 

     

    Methods: 

    This study was approved and by the Institutional Review Board (IRB). A retrospective cohort study was conducted with comprehensive electronic medical records review for 247 consecutive patients who underwent lung transplant at a single academic medical center between 2013 and 2016. The primary endpoint was POAF incidence. Secondary endpoints included the association between POAF and perioperative data. Comparisons were performed using Student’ t-tests and chi-square test. Significant variables were entered into a multivariable logistic regression model. 

      

    Results: 

    POAF occurred in 23.5% of the cohort (n = 58) with a mean onset of 4.8 ± 3.6 days [range, 0–18]. In univariable analysis, significant associations with POAF included older age (62.7 ± 7.5 vs 56.5 ± 13.4 years; P < .001), elevated body mass index (BMI) (26.4 ± 4.0 vs 24.5 ± 4.7; P < .001), preoperative history of atrial fibrillation (P = .02) and concomitant cardiac procedures (P = .03).  Multivariable logistic regression identified BMI (OR per 5 units, 1.64; 95% CI, 1.13–2.39; P = .009) and age (OR per decile, 1.73; 95% CI, 1.05–2.85; P = .03) as the only independent clinical predictors of POAF. 

      

    Conclusion: 

    POAF appears to be primarily driven by patient-specific factors such as advanced age, elevated BMI, and preoperative history of atrial fibrillation. However, only increased age and elevated BMI were independent predictors in our cohort. 

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