Key result
Postoperative atrial fibrillation occurred in 7.4% of adult liver transplant patients, with risk factors including age, MELD score, and prior AF increasing risk (OR 2.0-7.2, p<0.05).
Why the study?
What are the incidence, impact, and risk factors of postoperative atrial fibrillation in adult liver transplantation patients?
Cohort (n=1,387)
No
What are the incidence, impact, and risk factors of postoperative atrial fibrillation in adult liver transplantation patients?
Effect estimate: OR 2.0-7.2
p-value: p=<0.05
Postoperative atrial fibrillation occurs in 7.4% of liver transplant recipients and is associated with significantly increased mortality and morbidity, with identifiable risk factors that can guide prophylaxis.
POAF in liver transplant should not yet alter management; leaves open need for RCTs on risk-stratified prophylaxis.
Postoperative atrial fibrillation (POAF) is common after major surgeries and is associated with increased morbidity and mortality. POAF after liver transplantation (LT) has not been reported. This study was undertaken to investigate the incidence, impact, and risk factors of POAF in LT patients. After IRB approval, LT between January 2006 and August 2013 at our center were retrospectively reviewed. POAF that occurred within 30 days after LT was included. Patients with and without POAF were compared and independent risk factors were identified by logistic regression. Of 1387 adults LT patients, 102 (7.4%) developed POAF during the study period. POAF was associated with significantly increased mortality, graft failure, acute kidney injury and prolonged hospital stay. Independent risk factors included age, body weight, MELD score, presence of previous history of AF, the vasopressors use prior to LT and pulmonary artery diastolic pressure at the end of LT surgery (odds ratios 2.0-7.2, all p < 0.05). A risk index of POAF was developed and patients with the high-risk index had more than 60% chance of developing POAF. These findings may be used to stratify patients and to guide prophylaxis for POAF in the posttransplant period.
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Xia et al. (2015) conducted a cohort in Liver transplantation (n=1,387). Postoperative atrial fibrillation (POAF) and its risk factors vs. Patients without POAF / absence of risk factors was evaluated on Incidence of postoperative atrial fibrillation (POAF) within 30 days (OR 2.0-7.2, p=<0.05). Postoperative atrial fibrillation occurred in 7.4% of adult liver transplant patients, with risk factors including age, MELD score, and prior AF increasing risk (OR 2.0-7.2, p<0.05).
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