The association of pre‐transplant atrial fibrillation with in‐hospital outcomes in patients undergoing orthotopic liver transplantation: A propensity score matching analysis. Issue 12 (20th November 2022)

• Record Type: Journal Article
• Authors: Dangl, Michael; Grant, Jelani K.; Vincent, Louis; Ebner, Bertrand; Maning, Jennifer; Olorunfemi, Odunayo; Zablah, Gerardo; Sancassani, Rhea; Colombo, Rosario
• Is Part Of: Journal of cardiac surgery. Volume 37:Issue 12(2022)
• Page Start: 4762
• Page End: 4773
• Publication Date: 2022-11-20
• Subjects: atrial fibrillation -- liver transplantation -- outcomes; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.17183
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Introduction: In this study, we sought to evaluate the prevalence and association of pre‐transplant atrial fibrillation (AF) on 30‐day postoperative outcomes in patients undergoing orthotopic liver transplant (OLT). Method: The National Inpatient Sample Database was queried from 2011 to 2017 for relevant ICD‐9 and ICD‐10 procedural and diagnostic codes. Baseline characteristics and in‐hospital outcomes were compared in patients who underwent OLT with AF and those without. Results: Among 45, 357 patients who underwent OLT, women made up 35.8% of the overall population. The prevalence of AF before transplant was 2932 (6.5%) with a trend toward increasing prevalence, with an average annual change rate of 4.19%. Applying propensity score matching to control for potential confounding factors, there was no association between pre‐transplant AF and in‐hospital mortality in patients undergoing OLT, however there was a higher incidence of perioperative complications including: acute kidney injury, ventricular tachycardia, major bleeding, blood product transfusion, and septic shock. Conclusion: In patients undergoing OLT, pre‐transplant AF is increasing in prevalence and appears to be associated with similar in‐hospital mortality but worse perioperative outcomes. Greater emphasis should be placed on AF in the preoperative cardiovascular risk stratification of patients undergoing OLT.