Impact of Preoperative Inflammatory Indices and Postoperative Pneumonia on Postoperative Atrial Fibrillation in Patients with Non-Small Cell Lung Cancer: A Retrospective Study

Abstract

Background: This study aimed to evaluate the impact of preoperative inflammatory indices and postoperative pneumonia (POP) on postoperative atrial fibrillation (POAF) in non–small cell lung cancer (NSCLC) patients. Methods: All consecutive patients who underwent pulmonary resection at our hospital (January 2016-October 2019) were enrolled. Preoperative inflammatory indices, demographic data, surgical details, and postoperative conditions were analyzed. Univariate and multivariate analyses of risk factors associated with POAF were also conducted. Results: Among the 382 patients included in the study, 32 (8.38%) developed POAF. Approximately 31 patients (96.9%) developed atrial fibrillation within three days after surgery. The POAF group had a significantly greater mean age (68 years) than did the non-POAF group (62 years) (P=0.002). Additionally, compared with non-POAF patients, POAF patients exhibited an increased number of mediastinal lymph nodes (P<0.001) and mediastinal lymph node stations (P<0.001). The POAF group also had a greater intraoperative blood volume (P=0.006), longer surgical duration (P=0.022), greater incidence of POP (P=0.09), and greater drainage volume (P=0.003). TNM stage (P<0.001) and type of lung resection (P=0.049) were also associated with POAF. Compared to those in the non-POAF group, the POAF group had longer postoperative hospital stays (10.54 days vs. 9 days; P=0.001) and longer drainage times (7 days vs. 5 days; P=0.004). Multivariate analysis revealed age, POP grade, and TNM stage as independent predictors of POAF in NSCLC patients. Conclusion: Preoperative inflammatory indices were not significantly associated with POAF, but age, POP, and TNM stage were identified as independent predictors. Early-stage NSCLC patients may have a greater susceptibility to POAF than early-stage patients, although further validation is needed. Additionally, POAF was linked to a longer postoperative hospital stay.