| Perioperative atrial arrhythmias in noncardiothoracic patients: a review of risk factors and treatment strategies in the veteran population. | |
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MedLine Citation:
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PMID: 21056136 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Perioperative atrial arrhythmias (PAAs) in noncardiothoracic patients have poorly defined risk factors and management. METHODS: The surgical intensive care unit database was queried for patients who developed PAAs from 2008 to 2009. Demographics, comorbidities, preoperative data (electrocardiography, chest x-rays, laboratory results), medications, intraoperative variables, management, and outcomes of atrial arrhythmias were collected. Controls were randomly chosen in a 3:1 ratio. Comparisons were performed using χ² tests, Student's t tests, or nonparametric comparisons as appropriate. Multivariate logistic regression was performed. RESULTS: Five hundred sixty-one patients were admitted to the surgical intensive care unit. Three hundred fifty-four (63%) had noncardiothoracic surgery, and 30 (8.5%) developed PAAs. The mean age of patients with PAAs was 66 ± 7.3 years, compared with 64 ± 11 years for controls (P = NS), with most patients undergoing general (60%) and vascular (33%) surgery. PAA patients were more likely to have coronary artery disease (P = .029), cardiomegaly (P = .011), and premature atrial contractions (P = .016) and to take aspirin (P = .010). On multivariate logistic regression, predictors of atrial arrhythmias were premature atrial contractions, preoperative hypokalemia, intraoperative adverse events, and cardiomegaly. Most PAA patients received amiodarone (63%). Ten percent required electrical cardioversion, and 26% received anticoagulation. PAA patients had significantly longer intensive care unit lengths of stay (P = .032). CONCLUSION: Coronary artery disease, cardiomegaly, hypokalemia, and premature atrial contractions were significantly associated with PAAs in noncardiothoracic patients. Prospective studies are needed to define treatment guidelines. |
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Authors:
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Jennifer Marye Burris; Anuradha Subramanian; Shubhada Sansgiry; Carlos H Palacio; Faisal G Bakaeen; Samir S Awad |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: American journal of surgery Volume: 200 ISSN: 1879-1883 ISO Abbreviation: Am. J. Surg. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-08 Completed Date: 2011-01-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370473 Medline TA: Am J Surg Country: United States |
Other Details:
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Languages: eng Pagination: 601-5 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of General Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Amiodarone / therapeutic use Anti-Arrhythmia Agents / therapeutic use* Atrial Fibrillation / epidemiology*, etiology, therapy Electric Countershock / methods* Follow-Up Studies Hospital Mortality / trends Hospitals, Veterans Humans Incidence Intensive Care Units Length of Stay Middle Aged Perioperative Period* Practice Guidelines as Topic* Prognosis Retrospective Studies Risk Factors Surgical Procedures, Operative / adverse effects* United States / epidemiology Veterans* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 1951-25-3/Amiodarone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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