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Year 2022 Vol. 30 No 3

SCIENTIFIC PUBLICATIONS

E.E. ABDUROZIKOV 1, O.N. DZHIOEVA 2, 3, V.A. SHVARTZ 4, A.R. KISELEV 2, E.A. ROGOZHKINA 1, O.M. DRAPKINA 2

PREDICTORS OF MORTALITY AND POSTOPERATIVE ATRIAL FIBRILLATION AFTER NON-CARDIAC SURGERY

State Budgetary Health Institution, City Clinical Hospital
named after V.V. Veresaev of the Department of Health of Moscow 1,
"National Medical Research Center for Therapy and Preventive Medicine"
of the Ministry of Health of Russian Federation 2,
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
of the Ministry of Health of Russian Federation 3,
National Medical Research Center for Cardiovascular Surgery named after A.N. Bakulev
of the Ministry of Health of Russian Federation 4, Moscow,
Russian Federation

Objective. This paper specifically focuses on the study of determination of the predictors associated with the development of postoperative atrial fibrillation (POAF) and mortality rate after major abdominal non-cardiac surgical interventions.
Methods. The methodology «Case-control study» has been used. The study included 226 patients: 83 - with a fatal outcome (cases) and 143 – without a fatal outcome (control group).
Results. Independent predictors increasing risk of POAF developing were considered to be the followings: myocardial infarction in the anamnesis (MI) (OR 4.7, CI 2.2-10.1), cardiac arrhythmias (OR 5.0, CI 2.5-10.3), chronic kidney disease (CKD) (OR 8.7, CI 4.6-16.5), congestive heart failure (CHF) (OR 9.9, CI 5.2-19.1), diabetes (OR 4.0, CI 2-8), chronic obstructive pulmonary disease (COPD) (OR 8.6, CI 1.7-42.3), intraoperative infusion of more than 3 liters (OR 3.4, CI 1.6-7,4). Independent predictors increasing the risk of mortality rate were the followings: cardiac arrhythmias in the anamnesis (OR 3,4, CI 1.7-6,9), CKD (OR 248, CI 80-764), CHF 2-3 class (OR 6,8, CI 3,7-12,6), diabetes (OR 4.9, CI 2.3-9,6), COPD (OR CI 6,5, 1,3-32), intraoperative infusion of more than 3 liters (OR 2.9, CI 1.46-5.7), post-surgery fluid therapy of 3-5 liters (OR 2,9 1,6-5,0), POAF (OR 14,8, CI 7,4-29,4), thromboembolic complications (OR 37,9, CI 8,7-164). Age (>72 years) was statistically significant (p<0.001) was associated with POAF and with mortality rate.
Conclusion. In abdominal non-cardiac surgical interventions. the development of POAF is a common complication of cardiac surgery. In patients with POAF, the risk of in-hospital mortality is significantly higher. Independent factors that increase the risk of mortality rate and POAF are largely similar and in this study were the followings: myocardial infarction in the anamnesis, heart rate variabily, chronic heart failure, chronic renal failure, diabetes, chronic obstructive pulmonary disease, as well as relaporotomy, inflammation and pneumonia. The quantitative component of the «extra volume» of infusion therapy associated with perioperative complications was also recorded.

Keywords: postoperative atrial fibrillation, new onset atrial fibrillation, non-cardiac surgery, cardiovascular complications, mortality, surgery, inflammation
p. 245-254 of the original issue
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Address for correspondence:
Russian Federation, Moscow,
Rublevskoe highway 135,
Federal State Budgetary Institution «National Medical
Research Center for Cardiovascular Surgery named
after N.N. A.N. Bakulev» of the Ministry of Health
of Russian Federation.. Department of Surgical
Treatment of Interactive Pathology,
Tel. +79032619292
e-mail: shvartz.va@ya.ru
Shvartz Vladimir A.
Information about the authors:
Abdurozikov Eldor E., Physician of Functional Diagnostics, State Budgetary Health Institution, City Clinical Hospita named after V.V. Veresaev of the Department of Health of Moscow, Moscow, Russian Federation
https://orcid.org/0000-0002-5276-4032
Dzhioeva Olga N., MD, Senior Researcher, Department of Fundamental and Applied Aspects of Obesity, Federal State Budgetary Institution «National Medical Research Center for Therapy and Preventive Medicine» of the Ministry of Health of Russia; Associate Professor, Department of Therapy and Preventive Medicine, Federal State Budgetary Institution of Higher Education, Moscow State University of Medicine and Dentistry named after A.I. Evdokimov of the Ministry of Health of Russian Federation, Moscow, Russian Federation
https://orcid.org/0000-0002-5384-3795
Shvartz Vladimir A., MD, Researcher at the Department of Surgical Treatment of Interactive Pathology, Associate Professor of the Department of Cardiovascular Surgery with a Course in Arrhythmology and Clinical Electrophysiology, Federal State Budgetary Institution “National Medical Research Center for Cardiovascular Surgery named after A.N. Bakulev» of the Ministry of Health of Russian Federation,. Moscow, Russian Federation
https://orcid.org/0000-0002-8931-0376
Kiselev Anton R., MD, Head of the Center for the Coordination of Fundamental Scientific Activities, Federal State Budgetary Institution «National Medical Research Center for Therapy and Preventive Medicine» of the Ministry of Health of Russia, Moscow, Russian Federation
https://orcid.org/0000-0003-3967-3950
Rogozhkina Elizaveta A., Trainee Physician, City Clinical Hospital Named after V.V. Veresaev of the Department of Health of Moscow, Moscow, Russian Federation.
https://orcid.org/0000-0001-8993-7892
Drapkina Oksana M., Corresponding Member RAS, MD, Professor, Director Federal State Budgetary Institution «National Medical Research Center for Therapy and Preventive Medicine» of the Ministry of Health of Russian Federation, Head of the Department of Therapy and Preventive Medicine of Federal State Budgetary Institution of Higher Education, Moscow State University of Medicine and Dentistry Named after A.I. Evdokimov of the Ministry of Health of Russian Federaration, Moscow, Russian Federation.
https://orcid.org/0000-0002-4453-8430
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