Key result
Postoperative arrhythmia after liver surgery is linked to significantly shorter median survival of ~11 vs. 57 months.
Why the study?
New-onset postoperative arrhythmia is a known risk factor for morbidity and mortality after visceral surgery, but data concerning liver surgery were lacking.
Does new-onset postoperative arrhythmia reduce overall survival and increase postoperative morbidity in patients undergoing liver surgery?
Cohort (n=460)
No
Does new-onset postoperative arrhythmia reduce overall survival and increase postoperative morbidity in patients undergoing liver surgery?
Although new-onset postoperative arrhythmia occurs in only 5.4% of patients undergoing liver surgery, it is strongly associated with severe postoperative complications, prolonged ICU/IMC stay, and markedly reduced long-term overall survival.
Postoperative arrhythmia signals higher-risk liver surgery patients; leaves open whether prevention or monitoring improves survival.
Background: New-onset postoperative arrhythmia (PA) has previously been described as a pivotal risk factor for postoperative morbidity and mortality after visceral surgery. However, there is a lack of data concerning liver surgery. The incidence and impact of new-onset postoperative arrhythmia after liver surgery was, therefore, analyzed in a monocentric study. Methods: In total, n = 460 patients (221 female, 239 male) who underwent liver surgery between January 2012 and April 2020 without any prior arrhythmia in their medical history were included in this retrospective analysis. Clinical monitoring started with the induction of anesthesia and was terminated with discharge from the intensive care unit (ICU) or intermediate care unit (IMC). Follow-up included documentation of complications during the hospital stay, as well as long-term survival analysis. Results: Postoperative arrhythmia after liver surgery was observed in 25 patients, corresponding to an incidence of 5.4%. The occurrence of arrhythmia was significantly associated with intraoperative complications (p < 0.05), liver fibrosis/cirrhosis (p < 0.05), bile fistula/bile leakage/bilioma (p < 0.05), and organ failure (p < 0.01). Survival analysis showed a significantly poorer overall survival of patients who developed postoperative arrhythmia after liver surgery (p < 0.001). Conclusions: New-onset postoperative arrhythmia after liver surgery has an incidence of only 5.4% but is significantly associated with higher postoperative morbidity and poorer overall survival.
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Rühlmann et al. (2024) conducted a cohort in Liver surgery (n=460). New-onset postoperative arrhythmia vs. No postoperative arrhythmia was evaluated on Overall survival (median months) (p=<0.001). New-onset postoperative arrhythmia occurred in 5.4% of liver surgery patients and was associated with significantly shorter median overall survival (11.3 vs. 56.8 months, p<0.001).
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