March 25, 2019
View Full PaperMeta-analysis of risk factors and complications associated with atrial fibrillation after oesophagectomy
Key Result
Postoperative atrial fibrillation after oesophagectomy was associated with a significantly higher risk of overall postoperative adverse events (OR 5.50; 95% CI 3.51-8.30).
Study Design
Type
Meta-Analysis (n=9,087)
Structured PICO
Does new-onset postoperative atrial fibrillation increase the risk of adverse events and mortality in patients undergoing oesophagectomy for cancer?
P
Population
9,087 patients from 53 studies undergoing oesophagectomy, analyzed to assess the incidence and impact of postoperative atrial fibrillation.
E
Exposure
New-onset postoperative atrial fibrillation (exposure)
C
Comparator
Patients without postoperative atrial fibrillation
O
Outcome
Overall postoperative adverse events, 30-day mortality, anastomotic leak, and pneumoniahard clinical
Postoperative atrial fibrillation after oesophagectomy is common and strongly associated with an increased risk of 30-day mortality and postoperative complications.
Main Result
Odds Ratio: 5.5 (95% CI 3.51–8.3)
Abstract
Abstract Background Oesophagectomy is associated with high morbidity and mortality rates. New-onset atrial fibrillation (AF) is a frequent complication following oesophagectomy. Several studies have explored whether new-onset AF is associated with adverse events after oesophagectomy. Methods This review was performed according to PRISMA guidelines. Eligible studies were identified through a search of PubMed, Scopus and Cochrane CENTRAL databases up to 25 November 2018. A meta-analysis was conducted with the use of random-effects modelling. The I2 statistic was used to assess for heterogeneity. Results In total, 53 studies including 9087 patients were eligible for analysis. The overall incidence of postoperative AF was 16·5 per cent. Coronary artery disease and hypertension were associated with AF, whereas diabetes, smoking and chronic obstructive pulmonary disease were not. Patients with AF had a significantly higher risk of overall postoperative adverse events than those without fibrillation (odds ratio (OR) 5·50, 95 per cent c.i. 3·51 to 8·30), including 30-day mortality (OR 2·49, 1·70 to 3·64), anastomotic leak (OR 2·65, 1·53 to 4·59) and pneumonia (OR 3·42, 2·39 to 4·90). Conclusion Postoperative AF is frequently observed in patients undergoing oesophagectomy for cancer. It is associated with an increased risk of death and postoperative complications.