Incidence and implications of postoperative supraventricular tachycardia after pulmonary lobectomy.

TitleIncidence and implications of postoperative supraventricular tachycardia after pulmonary lobectomy.
Publication TypeJournal Article
Year of Publication2016
AuthorsGiambrone GP, Wu X, Gaber-Baylis LK, Bhat AU, Zabih R, Altorki NK, Fleischut PM, Stiles BM
JournalJ Thorac Cardiovasc Surg
Volume151
Issue4
Pagination982-8
Date Published2016 Apr
ISSN1097-685X
KeywordsAdolescent, Adult, Aged, Chi-Square Distribution, Databases, Factual, Female, Hospital Mortality, Humans, Incidence, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Pneumonectomy, Risk Factors, Stroke, Tachycardia, Supraventricular, Time Factors, Treatment Outcome, United States, Young Adult
Abstract

OBJECTIVE: We sought to determine the rate of postoperative supraventricular tachycardia (POSVT) in patients undergoing pulmonary lobectomy, and its association with adverse outcomes.

METHODS: Using the State Inpatient Database, from the Healthcare Cost and Utilization Project, we reviewed lobectomies performed (2009-2011) in California, Florida, and New York, to determine POSVT incidence. Patients were grouped by presence or absence of POSVT, with or without other complications. Stroke rates were analyzed independently from other complications. Multivariable regression analysis was used to determine factors associated with POSVT.

RESULTS: Among 20,695 lobectomies performed, 2449 (11.8%) patients had POSVT, including 1116 (5.4%) with isolated POSVT and 1333 (6.4%) with POSVT with other complications. Clinical predictors of POSVT included age ≥75 years, male gender, white race, chronic obstructive pulmonary disease, congestive heart failure, thoracotomy surgical approach, and pulmonary complications. POSVT was associated with an increase of: stroke (odds ratio [OR] 1.74; 95% confidence interval [CI] 1.03-2.94); in-hospital death (OR 1.85; 95% CI 1.45-2.35); LOS (OR 1.33; 95% CI 1.29-1.37); and readmission (OR 1.29; 95% CI 1.04-1.60). The stroke rate was <1% in patients who had isolated POSVT, and 1.5% in patients with POSVT with other complications. Patients with isolated POSVT had increased readmission and LOS, and a marginal increase in stroke rate, compared with patients with an uncomplicated course.

CONCLUSIONS: POSVT is common in patients undergoing pulmonary lobectomy and is associated with adverse outcomes. Comparative studies are needed to determine whether strict adherence to recently published guidelines will decrease the rate of stroke, readmission, and death after POSVT in thoracic surgical patients.

DOI10.1016/j.jtcvs.2015.11.057
Alternate JournalJ. Thorac. Cardiovasc. Surg.
PubMed ID26778376
PubMed Central IDPMC5124904
Grant ListUL1 TR000457 / TR / NCATS NIH HHS / United States
UL1-TR000457-06 / TR / NCATS NIH HHS / United States

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