Dipartimento Medicina Sperimentale e Clinica, Università Di Firenze, Viale Morgagni 85, 50134, Florence, Italy.
Medicina interna e postchirurgica AOU Careggi, Florence, Italy.
Intern Emerg Med. 2021 Mar;16(2):333-338. doi: 10.1007/s11739-020-02372-6. Epub 2020 May 21.
Few information exist about incidence and prognostic significance of postoperative atrial fibrillation (POAF) in patients undergoing hip fracture surgery. In the period comprised between January 2012 and December 2016, we evaluated 3129 patients referred for hip fracture. At hospital admission 277 were in permanent atrial fibrillation and were excluded from the study. POAF was defined as symptomatic or asymptomatic AF of duration > 10 min occurring during hospitalization after hip surgery. In-hospital and 1-year outcomes of POAF patients were compared to that of an age- and sex-matched hip fracture control group. Survival rates were estimated by Kaplan-Meier curves and differences between groups compared by log-rank test. One hundred and four patients (mean age 83.7 years, men 27%) developed POAF (3.6%). Time of onset after surgery was on average 2 days after surgery. Eight POAF patients died during hospitalization. 81.7% were discharged in sinus rhythm. Patients with POAF had a longer time to surgery (3.8 ± 3.3 vs. 2.4 ± 1.6 days, p = 0.0007) and length of hospital stay (19.7 ± 10.4 vs. 14.4 ± 5.1 days p < 0.0001) in comparison to control group. Eight patients had AF recurrence during follow-up. 1-year mortality was significantly higher in POAF group in comparison to control group (39.3. vs 20.9%, p < 0.001). Postoperative atrial fibrillation in patients undergoing hip fracture surgery is associated with a longer length of hospital stay in comparison to patients who maintain stable sinus rhythm. Moreover, these patients had a significant higher mortality at 1-year follow-up.
关于接受髋部骨折手术的患者术后心房颤动（POAF）的发生率和预后意义，相关信息有限。在 2012 年 1 月至 2016 年 12 月期间，我们评估了 3129 名接受髋部骨折手术的患者。入院时，277 例患者处于永久性心房颤动状态，被排除在研究之外。POAF 定义为髋部手术后住院期间持续时间超过 10 分钟的有症状或无症状的 AF。POAF 患者的住院期间和 1 年结局与年龄和性别匹配的髋部骨折对照组进行比较。通过 Kaplan-Meier 曲线估计生存率，并通过对数秩检验比较组间差异。104 例患者（平均年龄 83.7 岁，男性 27%）发生 POAF（3.6%）。术后发病时间平均为术后 2 天。8 例 POAF 患者在住院期间死亡。81.7%的患者出院时为窦性心律。POAF 患者的手术时间更长（3.8±3.3 天比 2.4±1.6 天，p=0.0007），住院时间更长（19.7±10.4 天比 14.4±5.1 天，p<0.0001）与对照组相比。8 例患者在随访期间出现 AF 复发。POAF 组的 1 年死亡率明显高于对照组（39.3%比 20.9%，p<0.001）。与维持稳定窦性心律的患者相比，接受髋部骨折手术的患者发生术后心房颤动与住院时间延长有关。此外，这些患者在 1 年随访时的死亡率显著更高。
