Risk Factors for Atrial Fibrillation After Lung Cancer Surgery: Analysis of The Society of Thoracic Surgeons General Thoracic Surgery Database

Background. Atrial fibrillation is responsible for significant morbidity after lung cancer surgery, and preoperative and perioperative risk factors are not well described. Methods. The Society of Thoracic Surgeons (STS) database was queried for all lobectomy and pneumonectomy patients with a diagnosis of lung cancer. A multivariable logistic regression model was developed to predict the risk of atrial arrhythmia as a function of preoperative and perioperative factors. Generalized estimating equations methodology was used to account for correlation among observations from the same institution. Missing data were handled using the method of chained equations with 10 randomly imputed data sets. Results. A total of 13,906 patients who underwent resection for lung cancer at participating institutions had complete information for postoperative atrial arrhythmia, of whom 1,755 (12.6%) experienced the outcome. Multivariable logistic analysis indentified increasing age, increasing extent of operation, male sex, nonblack race, and stage II or greater tumors as predictors of postoperative atrial fibrillation. Conclusions. Analysis of the STS database has identified five variables that predict postoperative atrial fibrillation. This predictive model may be useful to develop strategies for risk stratification, prophylaxis, and treatment. (Ann Thorac Surg 2010;90:368-74) (C) 2010 by The Society of Thoracic Surgeons