Incidence and impact of new-onset postoperative arrhythmia after surgery of the lower gastrointestinal tract
Abstract Postoperative arrhythmias (PAs) are common events and have been widely investigated in cardiothoracic surgery. Within visceral surgery, a recent study revealed a significant occurrence of PA in esophageal resections. In contrast, PA in lower gastrointestinal surgery is rarely investigated a...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-27508-4 |
| _version_ | 1828051783204732928 |
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| author | Felix Rühlmann Mara Sophie Hedicke Deborah Engelhardt Alma Franziska Mackert Tobias Tichelbäcker Andreas Leha Markus Bernhardt Michael Ghadimi Thorsten Perl Azadeh Azizian Jochen Gaedcke |
| author_facet | Felix Rühlmann Mara Sophie Hedicke Deborah Engelhardt Alma Franziska Mackert Tobias Tichelbäcker Andreas Leha Markus Bernhardt Michael Ghadimi Thorsten Perl Azadeh Azizian Jochen Gaedcke |
| author_sort | Felix Rühlmann |
| collection | DOAJ |
| description | Abstract Postoperative arrhythmias (PAs) are common events and have been widely investigated in cardiothoracic surgery. Within visceral surgery, a recent study revealed a significant occurrence of PA in esophageal resections. In contrast, PA in lower gastrointestinal surgery is rarely investigated and has been rudimentary described in the medical literature. The present work is a retrospective cohort study of 1171 patients who underwent surgery of lower gastrointestinal tract between 2012 and 2018. All included patients were treated and monitored in the intensive care unit (ICU) or intermediate care unit (IMC) after surgery. Follow-up, performed between January and May 2021, was obtained for the patients with PA investigating the possible persistence of PA and complications such as permanent arrhythmia or thromboembolic events after discharge. In total, n = 1171 patients (559 female, 612 male) without any history of prior arrhythmia were analyzed. Overall, PA occurred in n = 56 (4.8%) patients after surgery of the lower GI. The highest incidence of PA was seen in patients undergoing bowel surgery after mesenteric ischaemia (26.92%), followed by cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC; 16.67%). PA was significantly associated with higher age (72 years (IQR 63–78 years) vs. 64 years (IQR 55–73.5 years), p < 0.001) and longer length of stay in the ICU (median 15 days (IQR 5–25 days) vs. median 2 days (IQR 1–5 days), p < 0.001). PA was independently associated with organ failure (OR = 4.62, 95% CI 2.11–10.11, p < 0.001) and higher in-house mortality (OR = 3.37, 95% CI 1.23–9.28, p < 0.001). In median, PA occurred 66.5 h after surgery. In follow-up, 31% of all the patients with PA showed development of permanent arrhythmia. The incidence of PA after lower GI surgery is comparatively low. Its occurrence, however, seems to have severe implications since it is significantly associated with higher rates of organ failure and in-house mortality. Also, compared to the general population, the development of permanent arrhythmia is significantly higher in patients who developed new-onset PA. |
| first_indexed | 2024-04-10T19:43:35Z |
| format | Article |
| id | doaj.art-eaafd6ab6fa6492d80e792ba4fb40298 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-10T19:43:35Z |
| publishDate | 2023-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj.art-eaafd6ab6fa6492d80e792ba4fb402982023-01-29T12:11:55ZengNature PortfolioScientific Reports2045-23222023-01-011311910.1038/s41598-023-27508-4Incidence and impact of new-onset postoperative arrhythmia after surgery of the lower gastrointestinal tractFelix Rühlmann0Mara Sophie Hedicke1Deborah Engelhardt2Alma Franziska Mackert3Tobias Tichelbäcker4Andreas Leha5Markus Bernhardt6Michael Ghadimi7Thorsten Perl8Azadeh Azizian9Jochen Gaedcke10Department of General, Visceral, and Paediatric Surgery, University Medical Centre GöttingenDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre GöttingenDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre GöttingenDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre GöttingenClinic III for Internal Medicine, Heart Centre of University Hospital of CologneInstitute of Medical Statistics Göttingen, University Medical Centre GöttingenDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre GöttingenDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre GöttingenDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre GöttingenDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre GöttingenDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre GöttingenAbstract Postoperative arrhythmias (PAs) are common events and have been widely investigated in cardiothoracic surgery. Within visceral surgery, a recent study revealed a significant occurrence of PA in esophageal resections. In contrast, PA in lower gastrointestinal surgery is rarely investigated and has been rudimentary described in the medical literature. The present work is a retrospective cohort study of 1171 patients who underwent surgery of lower gastrointestinal tract between 2012 and 2018. All included patients were treated and monitored in the intensive care unit (ICU) or intermediate care unit (IMC) after surgery. Follow-up, performed between January and May 2021, was obtained for the patients with PA investigating the possible persistence of PA and complications such as permanent arrhythmia or thromboembolic events after discharge. In total, n = 1171 patients (559 female, 612 male) without any history of prior arrhythmia were analyzed. Overall, PA occurred in n = 56 (4.8%) patients after surgery of the lower GI. The highest incidence of PA was seen in patients undergoing bowel surgery after mesenteric ischaemia (26.92%), followed by cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC; 16.67%). PA was significantly associated with higher age (72 years (IQR 63–78 years) vs. 64 years (IQR 55–73.5 years), p < 0.001) and longer length of stay in the ICU (median 15 days (IQR 5–25 days) vs. median 2 days (IQR 1–5 days), p < 0.001). PA was independently associated with organ failure (OR = 4.62, 95% CI 2.11–10.11, p < 0.001) and higher in-house mortality (OR = 3.37, 95% CI 1.23–9.28, p < 0.001). In median, PA occurred 66.5 h after surgery. In follow-up, 31% of all the patients with PA showed development of permanent arrhythmia. The incidence of PA after lower GI surgery is comparatively low. Its occurrence, however, seems to have severe implications since it is significantly associated with higher rates of organ failure and in-house mortality. Also, compared to the general population, the development of permanent arrhythmia is significantly higher in patients who developed new-onset PA.https://doi.org/10.1038/s41598-023-27508-4 |
| spellingShingle | Felix Rühlmann Mara Sophie Hedicke Deborah Engelhardt Alma Franziska Mackert Tobias Tichelbäcker Andreas Leha Markus Bernhardt Michael Ghadimi Thorsten Perl Azadeh Azizian Jochen Gaedcke Incidence and impact of new-onset postoperative arrhythmia after surgery of the lower gastrointestinal tract Scientific Reports |
| title | Incidence and impact of new-onset postoperative arrhythmia after surgery of the lower gastrointestinal tract |
| title_full | Incidence and impact of new-onset postoperative arrhythmia after surgery of the lower gastrointestinal tract |
| title_fullStr | Incidence and impact of new-onset postoperative arrhythmia after surgery of the lower gastrointestinal tract |
| title_full_unstemmed | Incidence and impact of new-onset postoperative arrhythmia after surgery of the lower gastrointestinal tract |
| title_short | Incidence and impact of new-onset postoperative arrhythmia after surgery of the lower gastrointestinal tract |
| title_sort | incidence and impact of new onset postoperative arrhythmia after surgery of the lower gastrointestinal tract |
| url | https://doi.org/10.1038/s41598-023-27508-4 |
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