Predictors and prognostic impact of post-operative atrial fibrillation in patients with hip fracture surgery

BACKGROUND Atrial fibrillation (AF) is the most common arrhythmia developing in post-operative patients. Limited data are available regarding pre-operative risk factors and prognostic impact of post-operative AF (POAF) following hip fracture surgery (HFS) in Korean population. AIM We aimed to investigate the incidence, predictors, and hospital prognosis of POAF in HFS patients. METHODS This study included 245 patients without history of AF who underwent HFS between August 2014 and November 2016. POAF was defined as new-onset AF that occurred during hospitalization after HFS. RESULTS Twenty patients (8.2%) experienced POAF after HFS. POAF developed on median post-operative day 2 (interquartile range, 1-3). Multivariable logistic regression analysis showed that age [odds ratio (OR), 1.111; 95% confidence interval (CI), 1.022-1.209], chronic obstructive pulmonary disease (COPD) (OR, 6.352; 95%CI, 1.561-25.841) and E/e' ratio (OR, 1.174; 95%CI, 1.002-1.376) were significant predictors of POAF. Patients with POAF had a significantly higher intensive care unit admission rate (55.0% vs 14.7%, P < 0.001) and incidence of congestive heart failure (45.0% vs 10.7%, P < 0.001). In multivariable logistic regression analysis, POAF was significantly associated with increased incidence of congestive heart failure (OR, 4.856; 95%CI, 1.437-16.411) and intensive care unit admission (OR, 6.615; 95%CI, 2.112-20.718). CONCLUSION POAF was frequently developed in elderly patients following HFS. Age, COPD and elevated E/e' ratio were found as significant predictors of POAF in HFS patients. Patients with POAF significantly experienced intensive care unit admission and incident congestive heart failure during hospitalization.