Varon Ben, Kandel Leonid, Rivkin Gurion, Leibowitz David
Department of Cardiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Gerontology. 2021;67(6):681-686. doi: 10.1159/000514482. Epub 2021 Apr 1.
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common surgeries performed in elderly patients with osteoarthritis. Limited data address the clinical significance of perioperative atrial fibrillation (AF) in these patients. This study aimed to determine whether preexisting or new-onset AF is associated with increased 1-year all-cause mortality rates in the elderly population.
280 patients over the age of 60 undergoing THA or TKA with perioperative AF and 280 control-matched patients were retrospectively identified, and their files reviewed. The primary end point was 1-year all-cause mortality from the date of the surgery.
Of the 280 patients with perioperative AF, 37 had new-onset AF with a 1-year all-cause mortality rate of 10.8%. This mortality was significantly higher in patients with new-onset AF compared to patients without AF or patients with previous AF (10.8% vs. 1.1% and 2.5%, respectively; p = 0.005). On multivariate analysis, this difference remained significant after adjustment for risk factors associated with all-cause mortality.
One-year all-cause mortality in elderly patients undergoing TKA or THA is significantly increased in the patients that develop new postoperative AF. These patients warrant increased clinical surveillance following surgery.
全髋关节置换术（THA）和全膝关节置换术（TKA）是老年骨关节炎患者常见的手术。关于围手术期心房颤动（AF）在这些患者中的临床意义的数据有限。本研究旨在确定既往存在的或新发的AF是否与老年人群1年全因死亡率增加相关。
回顾性确定280例年龄超过60岁接受THA或TKA且伴有围手术期AF的患者以及280例匹配的对照患者，并查阅他们的病历。主要终点是自手术日期起的1年全因死亡率。
在280例围手术期AF患者中，37例为新发AF，其1年全因死亡率为10.8%。新发AF患者的死亡率显著高于无AF或既往有AF的患者（分别为10.8%对1.1%和2.5%；p = 0.005）。多因素分析显示，在调整与全因死亡率相关的危险因素后，这种差异仍然显著。
接受TKA或THA的老年患者中，术后新发AF的患者1年全因死亡率显著增加。这些患者术后需要加强临床监测。
