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Vol. 42. Issue 1.
Pages 9-13 (January 2006)
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Vol. 42. Issue 1.
Pages 9-13 (January 2006)
Original Articles
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Risk Factors for Atrial Fibrillation After Thoracic Surgery
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A. Gómez-Caroa,
Corresponding author
abelitov@yahoo.es

Correspondence: Dr. A. Gómez-Caro. Servicio de Cirugía Torácica. Hospital Universitario 12 de Octubre. Ctra. de Andalucía, km 5,400. 28041 Madrid. España
, F.J. Moradiellosa, P. Ausínb, V. Díaz-Hellína, E. Larrúa, J.A. Pérez-Antóna, J.L. Martín de Nicolása
a Servicio de Cirugía Torácica, Hospital Universitario 12 de Octubre, Madrid, Spain
b Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, Spain
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Objective

To determine the risk factors for atrial fibrillation after lung resection.

Patients and method

Between January 2002 and December 2003, 149 patients underwent lung resection in our hospital. For all these patients, clinical, surgical, analytical, and oncological data were prospectively collected. The data were subjected to univariate analysis.

Results

The mean (SD) age of the 127 men (85.2%) and 22 women (14.8%) who underwent lung resection was 61.8 (12.3) years (range, 17–79 years). Atrial fibrillation was documented in 17 patients (11.4%). Mortality at 30 days was 8.1%. The following risk factors for atrial fibrillation were identified: age 70 years or older (P< .0004), prior heart disease (P<.005), patients undergoing operations for lung cancer (P< .04), and type of resection–right bilobectomy (P < .05) and left pneumonectomy (P< .03). Hypertension, chronic obstructive pulmonary disease, and lung cancer stage were not risk factors. Likewise, systematic lymph node dissection and other forms of lung resection were not risk factors.

Conclusions

After lung resection, atrial fibrillation is a common complication that seems to be associated with old age, history of heart disease, operations for lung cancer, left pneumectomy, and right bilobectomy. The identification of these risk factors may encourage prospective studies that assess the use of antiarrhythmic drugs to prevent atrial fibrillation during chest surgery.

Key words:
Atrial fibrillation
Lung resection
Complications
Risk factors
Lung cancer
Objetivo

Determinar los factores de riesgo en la fibrilación auricular (FA) tras la resección pulmonar.

Patientes y método

Entre enero de 2002 y diciembre de 2003 se realizaron en nuestro servicio 149 resecciones anató-micas pulmonares. Se recogieron prospectivamente las ca-racterísticas clínicas, quirúrgicas, analíticas y oncológicas de todos los pacientes intervenidos. Se realizó un análisis univa-riante de todas las variables registradas.

Resultados

La edad media (± desviación estándar) de los pacientes operados -127 varones (85,2%) y 22 mujeres (14,8%)- fue de 61,8 ± 12,3 años (rango: 17–79). Se detecta-ron 17 casos de FA (11,4%). La mortalidad a los 30 días fue del 8,1%. Se detectaron los siguientes factores de riesgo de presentar FA: edad > 70 años (p < 0,0004), enfermedad car-díaca previa (p < 0,005), pacientes operados por carcinoma broncogénico (p < 0,04) y tipo de resección -bilobectomía derecha (p < 0,05) y neumonectomía izquierda (p < 0,03)-. No fueron factores de riesgo la hipertensión arterial, la enfermedad pulmonar obstructiva crónica, el estadio del carcinoma broncogénico, la disección mediastínica sistemática ni otro tipo distinto de resección pulmonar.

Conclusiones

La aparición de FA después de la resección pulmonar anatómica es una complicación frecuente que pare-ce asociarse en nuestra serie a edad avanzada, antecedentes de cardiopatía, intervención por carcinoma broncogénico, neumonectomía izquierda y bilobectomía derecha. La identificación de estos factores de riesgo puede ser de utilidad para iniciar estudios prospectivos encaminados a valorar el uso de fármacos antiarrítmicos para prevenir esta complicación.

Palabras clave:
Fibrilación auricular
Resección pulmonar
Complicaciones
Factores de riesgo
Cáncer de pulmón
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Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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