Intraoperative hypotension, new onset atrial fibrillation, and adverse outcome after carotid endarterectomy

Sposato, Luciano A.; Suárez, Andrés; Jauregui, A.; Riccio, Patricia M.; Altounian, Matías; Andreoli, Mauro G.; Rodríguez, Andrés; Ressia, Juan F.; Bressan, Gabriela J.; Klein, Francisco; Raffaelli, Héctor; Bozovich, Gerardo E.

doi:10.1016/j.jns.2011.07.052

Cited by 19 publications

(23 citation statements)

References 25 publications

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“…However, previous studies have found that the rate of new-onset atrial fibrillation is very low (<3%) after carotid revascularization. 22,23 Therefore, the atrial fibrillation diagnoses are almost exclusively based on preprocedure diagnosis. Data are lacking on the anatomic factors, including severity of carotid artery stenosis, vessel tortuosity, vascular calcifications, and status of contralateral carotid artery, that are considered high-risk features for carotid interventions and important covariates to be included in the analysis.…”

Section: Discussionmentioning

confidence: 99%

The effect of atrial fibrillation on outcomes in patients undergoing carotid endarterectomy or stent placement in general practice

Watanabe

Chaudhry

Adil

et al. 2015

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

The effect of atrial fibrillation on outcomes in patients undergoing carotid endarterectomy or stent placement in general practice

Watanabe

Chaudhry

Adil

et al. 2015

Journal of Vascular Surgery

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“…The influence of IOH has been confirmed in transplantation surgery. IOH is an independent predictor of kidney rejection [7], as well as the appearance of new onset atrial fibrillation (NOAF) after carotid endarterectomy [8]. …”

Section: Introductionmentioning

confidence: 99%

Risk factors for intraoperative hypotension during thyroid surgery

Kalezić

Stojanović²,

Ladjević³

et al. 2013

Med Sci Monit

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BackgroundHypotension is a common adverse effect of IV anaesthetics, especially during the induction of anaesthesia. The aim of our study was to determine the incidence and risk factors for intraoperative hypotension (IOH) in thyroid surgery, as well as to determine whether and to what extent IOH affects the occurrence of postoperative hypotension.Material/MethodsThe study included 1252 euthyroid patients, ASA 2 and ASA 3 status (American Society of Anesthesiologists physical status classification), who had thyroid surgery between 2007 and 2011. IOH was defined as a decrease in systolic blood pressure of >20% of baseline values. We studied the influence of demographic characteristics (sex, age, body mass index-BMI), comorbidity, type and duration of surgery, and anaesthesia on the occurrence of IOH. Univariate and multivariate logistic regression were used to determine predictors of occurrence of IOH.ResultsIOH was registered in 6.5% of patients. The most common operation was thyroidectomy. Patients with IOH were younger, had lower BMI, and significantly less often had hypertension as a coexisting disease. The multivariate regression model identified BMI and the absence of hypertension as a coexisting disease, and as independent predictors of occurrence of IOH. Significantly more patients with IOH had postoperative hypotension (9.9% vs. 2.4%, p=0.000).ConclusionsIOH is common, even during operations of short duration and with minimal bleeding. It is necessary to pay special attention to these patients, given that many of these patients remained hypotensive during the postoperative period.

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“…Forty studies were excluded as they did not meet the eligibility criteria. Finally, 11 studies met the inclusion criteria and were included in this SRMA (Figure 1) [19][20][21][22][23][24][25][26][27][28][29]. ese studies were analysed with respect to risk factors and outcomes associated with the perioperative AF.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding gender, eleven of the included studies consisting of 121,517 patients reported on gender (perioperative AF versus control: 2944 versus 118,573) [19][20][21][22][23][24][25][26][27][28][29]. ere was a higher incidence of perioperative AF in males versus females (perioperative AF versus control: 1556 versus 51692: 52.85% versus 43.59%; OR: 1.08; 95% CI: 0.54 to 1.62; I 2 : 84%; P < 0.0001) (Figure 3).…”

Section: Demographicsmentioning

confidence: 99%

Incidence, Risk Factors, and Outcomes of Perioperative Atrial Fibrillation following Noncardiothoracic Surgery: A Systematic Review and Meta-Regression Analysis of Observational Studies

Subramani

Tohamy

Jalali

et al. 2021

Anesthesiology Research and Practice

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Background. Atrial fibrillation (AF) occurs in 16–30% of patients after cardiac and thoracic surgery and can lead to serious complications like hypoperfusion of vital organs, pulmonary edema, and myocardial infarction. The evidence on risk factors and complications associated with perioperative AF after noncardiothoracic surgery is limited. Methods. The primary objective was to determine demographic and clinical risk factors for new-onset atrial fibrillation associated with noncardiothoracic surgery. A secondary aim was to identify the incidence and odds of perioperative complications associated with the new-onset atrial fibrillation. A systematic search within multiple databases was conducted for studies that explicitly reported on new-onset atrial fibrillation after noncardiothoracic surgery. We reported data on demographics, comorbidities, and perioperative complications as mean difference (MD) or odds ratios (OR) and corresponding 95% confidence interval (CI) using random effects models. A two-sided P value of less than 0.05 was considered significant. We performed meta-regression and sensitivity analysis of various subgroups to confirm the inference of our findings. Results. Eleven studies reporting on 121,517 patients were included, of whom 2,944 developed perioperative AF (incidence rate: 3.7%; 95% CI: 2.3%––6.2%). Advanced age (AF group versus control group: 69.36 ± 10.5 versus 64.37 ± 9.53 years; MD: 4.06; 95% CI: 1.67––6.44; P = 0.0009 ), male gender (52.85% versus 43.59%; OR: 1.08; 95% CI: 0.54 to 1.62; I2: 84%; P < 0.0001 ), preoperative hypertension (60.42% versus 56.51%; OR: 1.15; 95% CI: 1.08 to 1.23; I2: 0%; P < 0.00001 ), diabetes mellitus (22.6% versus 23.04%; OR: 0.97; 95% CI: 0.89 to 1.05; I2: 0; P < 0.00001 ), and cardiac disease (30.64% versus 8.49%; OR: 2.3; 95% CI: 0.28 to 4.31; I2: 93%; P = 0.03 ) were found to be significant predictors for perioperative AF. The AF group was at increased odds of developing postoperative cardiac complications (34.1% versus 5%; OR: 5.44; 95% CI: 0.49 to 10.39; I2: 82%; P = 0.03 ), postoperative stroke (0.5% versus 0.1%; OR: 3; 95% CI: 0.65 to 5.35; I2: 0%; P = 0.01 ), and mortality (7.40% versus 1.92%; OR: 3.58; 95% CI: 0.14 to 7.02; I2: 0%; P = 0.04 ). Study quality assessment by meta-regression and sensitivity analysis of the various subgroups did not affect the final inference of the results. Conclusion. We identified advanced age, male gender, preoperative hypertension, diabetes mellitus, and cardiac disease as important risk factors for perioperative atrial fibrillation. The atrial fibrillation group was at increased odds for postoperative cardiac complications, stroke, and higher mortality, emphasizing the need for risk stratification and close monitoring.

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Intraoperative hypotension, new onset atrial fibrillation, and adverse outcome after carotid endarterectomy

Cited by 19 publications

References 25 publications

The effect of atrial fibrillation on outcomes in patients undergoing carotid endarterectomy or stent placement in general practice

The effect of atrial fibrillation on outcomes in patients undergoing carotid endarterectomy or stent placement in general practice

Risk factors for intraoperative hypotension during thyroid surgery

Incidence, Risk Factors, and Outcomes of Perioperative Atrial Fibrillation following Noncardiothoracic Surgery: A Systematic Review and Meta-Regression Analysis of Observational Studies

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