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. 2024 Jan 25;12(2):271.
doi: 10.3390/biomedicines12020271.

Short- and Long-Term Outcomes of Patients with Postoperative Arrhythmia after Liver Surgery

Felix Rühlmann  1 , Deborah Engelhardt  1 , Alma Franziska Mackert  1 , Mara Sophie Hedicke  1 , Tobias Tichelbäcker  2 , Andreas Leha  3 , Markus Bernhardt  1 , Michael Ghadimi  1 , Thorsten Perl  1 , Azadeh Azizian  1 , Jochen Gaedcke  1
Affiliations

Short- and Long-Term Outcomes of Patients with Postoperative Arrhythmia after Liver Surgery

Felix Rühlmann et al. Biomedicines. .

Abstract

Background: New-onset postoperative arrhythmia (PA) has previously been described as a pivotal risk factor for postoperative morbidity and mortality after visceral surgery. However, there is a lack of data concerning liver surgery. The incidence and impact of new-onset postoperative arrhythmia after liver surgery was, therefore, analyzed in a monocentric study.

Methods: In total, n = 460 patients (221 female, 239 male) who underwent liver surgery between January 2012 and April 2020 without any prior arrhythmia in their medical history were included in this retrospective analysis. Clinical monitoring started with the induction of anesthesia and was terminated with discharge from the intensive care unit (ICU) or intermediate care unit (IMC). Follow-up included documentation of complications during the hospital stay, as well as long-term survival analysis.

Results: Postoperative arrhythmia after liver surgery was observed in 25 patients, corresponding to an incidence of 5.4%. The occurrence of arrhythmia was significantly associated with intraoperative complications (p < 0.05), liver fibrosis/cirrhosis (p < 0.05), bile fistula/bile leakage/bilioma (p < 0.05), and organ failure (p < 0.01). Survival analysis showed a significantly poorer overall survival of patients who developed postoperative arrhythmia after liver surgery (p < 0.001).

Conclusions: New-onset postoperative arrhythmia after liver surgery has an incidence of only 5.4% but is significantly associated with higher postoperative morbidity and poorer overall survival.

Keywords: liver surgery; perioperative medicine; perioperative risk stratification; postoperative new-onset arrhythmia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Odds ratios with 95% confidence intervals of variables in the final logistic regression model for the postoperative development of arrhythmia (asterisks indicate the level of significance: p < 0.05 *, p < 0.01 **).
Figure 2
Figure 2
Odds ratios with 95% confidence intervals of variables in the final logistic regression model for postoperative in-house mortality (asterisks indicate the level of significance: p < 0.05 *, p < 0.01 **, p < 0.001 ***).
Figure 3
Figure 3
Kaplan–Meier curve of patients with PA (red) and without PA (blue) after liver surgery. A significant difference in overall survival was obtained; χ2(1) = 26.9, p < 0.001.
See this image and copyright information in PMC

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