Surgery Intensive Care Unit, China-Japan Friendship Hospital, Beijing, China.
Department of Orthopedic Surgery, China-Japan Friendship Hospital, Beijing, China.
Aging Clin Exp Res. 2020 May;32(5):921-924. doi: 10.1007/s40520-019-01271-x. Epub 2019 Jul 30.
The purpose of this study is to determine whether new-onset postoperative atrial fibrillation (NOPAF) among patients after hip arthroplasty can predict 1-year mortality.
All patients over 65 years who underwent hip arthroplasty from January 2013 to December 2017 in a Chinese tertiary hospital were retrospectively analyzed. Patients with paroxysmal and persistent atrial fibrillation were ruled out. 2438 patients were identified to be eligible. The primary endpoint was 1-year mortality after the arthroplasty.
Among the 2438 patients, 101 (4.1%) had NOPAF and 2337 (95.9%) had not. Only the current use of beta blocker could predict the occurrence of NOPAF after hip arthroplasty. 1-year mortality for patients with NOPAF was significantly higher than that for patients without NOPAF (70.3% vs 19.0%; p < 0.001). Anti-arrhythmic and anticoagulant treatments were related to 1-year mortality, respectively. With multivariate analysis, NOPA was the most significant variable related to 1-year mortality (hazard ratio 7.8, 95% CI 2.9-24.6).
Among elderly patients after hip arthroplasty, 1-year mortality is increased significantly for patients with NOPAF.
本研究旨在确定髋关节置换术后新发的心房颤动（NOPAF）是否可以预测 1 年死亡率。
回顾性分析 2013 年 1 月至 2017 年 12 月在中国一家三级医院接受髋关节置换术的所有 65 岁以上患者。排除阵发性和持续性心房颤动患者。共确定 2438 例患者符合条件。主要终点是手术后 1 年的死亡率。
在 2438 例患者中，101 例（4.1%）发生了 NOPAF，2337 例（95.9%）未发生。只有当前使用β受体阻滞剂才能预测髋关节置换术后 NOPAF 的发生。NOPAF 患者的 1 年死亡率明显高于无 NOPAF 患者（70.3%比 19.0%；p<0.001）。抗心律失常和抗凝治疗与 1 年死亡率相关。多变量分析显示，NOPA 是与 1 年死亡率最显著相关的变量（危险比 7.8，95%CI 2.9-24.6）。
在髋关节置换术后的老年患者中，NOPAF 患者的 1 年死亡率显著增加。
