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©The Author(s) 2025.
World J Crit Care Med. Sep 9, 2025; 14(3): 102991
Published online Sep 9, 2025. doi: 10.5492/wjccm.v14.i3.102991
Published online Sep 9, 2025. doi: 10.5492/wjccm.v14.i3.102991
Table 1 Baseline characteristics of the study population, n (%)
| Variables of interest | POAF, hx (n = 22) | POAF, no hx (n = 23) | No POAF, hx (n = 35) | No POAF, no hx (n = 267) | Overall (n = 347) | P value |
| Demographics | ||||||
| Age, mean (SD) | 76.7 (9.4) | 79.6 (9.1) | 76.1 (10.7) | 68.1 (14.8) | 70.2 (14.3) | < 0.001 |
| Male | 14 (63.6) | 10 (43.5) | 21 (60) | 130 (48.7) | 175 (50.4) | 0.316 |
| BMI, mean, (SD) | 29.3 (8.7) | 27.1 (4.5) | 26.9 (6.9) | 26.8 (7.4) | 27.0 (7.3) | 0.405 |
| Race | 0.001 | |||||
| Asian | 3 (13.6) | 4 (17.4) | 5 (14.3) | 51 (19.1) | 63 (18.2) | |
| Black | 2 (9.1) | 5 (21.7) | 6 (17.1) | 58 (21.7) | 71 (20.5) | |
| Hispanic | 0 (0.0) | 1 (4.3) | 3 (8.6) | 63 (23.6) | 67 (19.3) | |
| White | 16 (72.7) | 11 (47.8) | 17 (48.6) | 77 (28.8) | 121 (34.9) | |
| Comorbidities | ||||||
| Hypertension | 19 (86.4) | 20 (87.0) | 32 (91.4) | 190 (71.2) | 261 (75.2) | 0.014 |
| Diabetes mellitus | 9 (40.9) | 8 (34.8) | 16 (45.7) | 125 (46.8) | 158 (45.5) | 0.706 |
| Congestive heart failure | 4 (18.2) | 2 (8.7) | 12 (34.3) | 31 (11.6) | 49 (14.1) | 0.006 |
| Stroke/transient ischemic attack history | 2 (9.1) | 2 (8.7) | 13 (37.1) | 34 (12.7) | 51 (14.7) | 0.004 |
| Coronary artery disease | 8 (36.4) | 3 (13.0) | 12 (34.3) | 44 (16.5) | 67 (19.3) | 0.013 |
| Hyperlipidemia | 9 (40.9) | 7 (30.4) | 16 (45.7) | 78 (29.2) | 110 (31.7) | 0.179 |
| Chronic kidney disease | 4 (18.2) | 1 (4.3) | 6 (17.1) | 39 (14.6) | 50 (14.4) | 0.483 |
| Cancer | 2 (9.1) | 6 (26.1) | 5 (14.3) | 62 (23.2) | 75 (21.6) | 0.296 |
Table 2 Main laboratory parameters, n (%)
| Variables of interest | POAF, hx (n = 22) | POAF, no hx (n = 23) | No POAF, hx (n = 35) | No POAF, no hx (n = 267) | Overall (n = 347) | P value |
| Laboratory parameters (mean/SD, median/IQR) | ||||||
| Hemoglobin (mean, SD) | 8.7 (1.7) | 8.4 (1.8) | 8.0 (1.4) | 8.5 (1.8) | 8.5 (1.7) | 0.344 |
| Brain natriuretic peptide (median, IQR) | 5090 (3770-9840) | 18900 (8740-29500) | 2590 (1100-5960) | 2420 (918-7810) | 3270 (1180-10000) | 0.002 |
| Lactate (median, IQR) | 1.5 (1.3-2.3) | 3.3 (2.2-5.3) | 2.3 (1.5-3.1) | 1.8 (1.2-3.3) | 1.9 (1.2-3.5) | 0.091 |
| Left Atrium diameter (mean, SD) | 43.6 (5) | 38.7 (3.5) | 43.6 (7.7) | 38.5 (5.6) | 39.5 (6) | < 0.001 |
| Left ventricular ejection fraction (mean %, SD) | 57.0 (8.5) | 57.7 (9.3) | 55.3 (10.4) | 57.0 (10.5) | 56.9 (10.2) | 0.692 |
| Electrolytes | ||||||
| Sodium (mean, SD) | 136 (4.1) | 133 (7.2) | 136 (5.8) | 134 (4.8) | 135 (5.1) | 0.186 |
| Potassium (median, IQR) | 3.5 (3.1-3.8) | 3.3 (3.1-4) | 3.8 (3.5-4.2) | 3.5 (3.2-3.8) | 3.6 (3.2-3.8) | 0.130 |
| Calcium (median, IQR) | 7.1(6.5-7.6) | 7 (6.5-7.5) | 7.5 (7-8.3) | 7.4 (6.7-8.0) | 7.3 (6.7-8.0) | 0.076 |
| Magnesium (mean, SD) | 1.7 (0.3) | 1.6 (0.3) | 1.7 (0.3) | 1.6 (0.3) | 1.6 (0.3) | 0.688 |
| Phosphorus (median, IQR) | 2.7 (2.1-3.2) | 2.5 (2.2-3.9) | 2.8 (2.2-3.8) | 2.7 (2.2-3.5) | 2.7 (2.2-3.5) | 0.977 |
Table 3 Procedural characteristics, n (%)
| Variables of interest | POAF, hx (n = 22) | POAF, no hx (n = 23) | No POAF, hx (n = 35) | No POAF, no hx (n = 267) | Overall (n = 347) | P value |
| Procedural characteristics | ||||||
| Type of procedure | ||||||
| Above the knee amputation | 2 (9.1) | 1 (4.3) | 15 (42.9) | 38 (14.2) | 56 (16.1) | < 0.001 |
| Below the knee amputation | 0 (0.0) | 0 (0.0) | 3 (8.6) | 20 (7.5) | 23 (6.6) | 0.388 |
| Exploratory laparotomy | 20 (90.9) | 22 (95.7) | 17 (48.6) | 208 (77.9) | 267 (76.9) | < 0.001 |
| Duration of procedure, [mean, (SD)] | 2.9 (1.3) | 2.7 (1.0) | 2.3 (1.1) | 2.6 (1.2) | 2.6 (1.2) | 0.169 |
| Preoperative b-blocker | 7 (31.8) | 7 (30.4) | 12 (34.3) | 61 (22.8) | 87 (25.1) | 0.322 |
| Type of anesthesia | ||||||
| general endotracheal anesthesia | 20 (90.9) | 17 (73.9) | 25 (71.4) | 217 (81.3) | 279 (80.4) | 0.0764 |
| Regional | 1 (4.5) | 1 (4.3) | 8 (22.9) | 26 (9.7) | 36 (10.4) | |
| Monitored anesthesia care | 0 (0.0) | 1 (4.3) | 1 (2.9) | 2 (0.7) | 4 (1.2) | |
| Combined anesthesia techniques | 1 (4.5) | 4 (17.4) | 1 (2.9) | 22 (8.2) | 28 (8.1) | |
| Mean intraoperative IVF intake [mean, (SD) mL] | 2900 (2040) | 2420 (1340) | 1340 (1420) | 2280 (1980) | 2240 (1920) | 0.001 |
Table 4 Main outcomes and atrial fibrillation treatment, n (%)
| Variables of Interest | POAF, hx (n = 22) | POAF, no hx (n = 23) | No POAF, hx (n = 35) | No POAF, no hx (n = 267) | Overall (n = 347) | P value |
| Outcome | ||||||
| Stroke | 0 (0.0) | 0 (0.0) | 1 (2.9) | 8 (3.0) | 9 (2.6) | 1.000 |
| Myocardial infarction | 2 (9.1) | 3 (13.0) | 0 (0.0) | 6 (2.2) | 11 (3.2) | 0.018 |
| Major adverse limb event | 1 (4.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (0.3) | 0.064 |
| Systemic embolism | 0 (0.0) | 0 (0.0) | 0 (0.0) | 6 (2.2) | 6 (1.7) | 1.000 |
| Major bleeding | 7 (31.8) | 6 (26.1) | 5 (14.3) | 38 (14.2) | 56 (16.1) | 0.093 |
| Cardiac arrest | 7 (31.8) | 8 (34.8) | 2 (5.7) | 39 (14.6) | 56 (16.1) | 0.005 |
| Postoperative day of POAF (mean, SD days) | 8.9 (19.4) | 7.9 (7.6) | - | - | - | 0.073 |
| ICU-LOS in days (median, IQR) | 11.5 (6.3-17.8) | 9.0 (5.0-22.0) | 5.0 (0.0-11.5) | 4.0 (1.0-8.0) | 5.0 (2.0-10.0) | < 0.001 |
| All-cause mortality | 6 (27.3) | 10 (43.5) | 3 (8.6) | 47 (17.6) | 66 (19.0) | < 0.001 |
| POAF treatment | ||||||
| B-blocker | 16 (72.7) | 13 (56.5) | - | - | - | 0.353 |
| Calcium channel blockers | 5 (22.7) | 5 (21.7) | - | - | - | 1.000 |
| Amiodarone | 6 (27.3) | 6 (26.1) | - | - | - | 1.000 |
| DOAC | 3 (13.6) | 1 (4.3) | - | - | - | 0.346 |
| Warfarin | 0 (0.0) | 2 (8.7) | - | - | - | 0.489 |
| Heparin infusion | 1 (4.5) | 2 (8.7) | - | - | - | 1.000 |
Table 5 Multivariable analyses: Postoperative atrial fibrillation
| Variables of interest | New onset POAF (without AF hx) | POAF (with/without AF hx) | ||||
| Variables | OR | 95%CI | P value | OR | 95%CI | P value |
| Age | 1.08 | 1.02-1.15 | 0.008 | 1.06 | 1.02-1.10 | 0.005 |
| Race: White | 1.48 | 0.48-4.62 | 0.493 | 2.85 | 1.26-6.76 | 0.014 |
| Left atrium diameter | 0.96 | 0.86-1.06 | 0.474 | 1.06 | 0.99-1.13 | 0.076 |
| Intraoperative IVF intake | 1 | 1.00-1.00 | 0.284 | 1 | 1.00-1.00 | 0.018 |
| ICU-LOS | 1.02 | 0.97-1.07 | 0.336 | 1.04 | 1.00-1.08 | 0.023 |
Table 6 Multivariable analyses: Mortality
| Model 1 | Model 2 | Model 3 | |||||||
| Variables | OR | 95%CI | P value | OR | 95%CI | P value | OR | 95%CI | P value |
| POAF, hx | 1.76 | 0.60-4.52 | 0.265 | 1.51 | 0.49-4.13 | 0.444 | 0.75 | 0.19-2.59 | 0.667 |
| POAF, no hx | 3.60 | 1.46-8.69 | 0.004 | 3.07 | 1.14-8.01 | 0.022 | 0.82 | 0.19-2.84 | 0.773 |
| No POAF, hx | 0.44 | 0.10-1.29 | 0.187 | 0.44 | 0.10-1.35 | 0.201 | 0.23 | 0.03-1.01 | 0.091 |
| Age | - | - | - | 1.01 | 0.99-1.03 | 0.408 | 1.02 | 0.99-1.05 | 0.248 |
| Race: White | - | - | - | 1.58 | 0.86-2.89 | 0.134 | 1.26 | 0.61-2.59 | 0.532 |
| Left atrium diameter | - | - | - | - | - | - | 1.00 | 0.93-1.06 | 0.908 |
| Intraoperative IVF intake | - | - | - | - | - | - | 1.00 | 1.00-1.00 | 0.096 |
| ICU-LOS | - | - | - | - | - | - | 1.05 | 1.02-1.09 | 0.002 |
- Citation: Giannis D, Zhao R, Fernandez L, Nikolov N, Sneed C, Kiarie P, Miele A, Louis MA, Mandava NR. Postoperative atrial fibrillation in emergent non-cardiac surgery: Risk factors and outcomes from a ten-year intensive-care unit retrospective study. World J Crit Care Med 2025; 14(3): 102991
- URL: https://www.wjgnet.com/2220-3141/full/v14/i3/102991.htm
- DOI: https://dx.doi.org/10.5492/wjccm.v14.i3.102991