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The Association of Pre-Transplant Atrial Fibrillation with In-Hospital Outcomes in Patients Undergoing Orthotopic Liver Transplantation: A Propensity Score Matching Analysis
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  • Michael Dangl,
  • Jelani Grant,
  • Louis Vincent,
  • Bertrand Ebner,
  • Jennifer Maning,
  • Odunayo Olorunfemi,
  • Neal Olarte,
  • Gerardo Zablah,
  • Rhea Sancassani,
  • Rosario Colombo
Michael Dangl
University of Miami School of Medicine

Corresponding Author:[email protected]

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Jelani Grant
University of Miami School of Medicine
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Louis Vincent
University of Miami School of Medicine
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Bertrand Ebner
University of Miami School of Medicine
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Jennifer Maning
University of Miami School of Medicine
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Odunayo Olorunfemi
University of Miami School of Medicine
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Neal Olarte
University of Miami School of Medicine
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Gerardo Zablah
University of Miami School of Medicine
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Rhea Sancassani
University of Miami School of Medicine
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Rosario Colombo
University of Miami School of Medicine
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Abstract

In this study, we sought to evaluate the prevalence and association of pre-transplant atrial fibrillation (AF) on 30-day postoperative outcomes in patients undergoing orthotopic liver transplant (OLT). The National Inpatient Sample Database was queried from 2011 to 2017 for relevant ICD-9 and ICD-10 procedural and diagnostic codes. Baseline characteristics and in-hospital outcomes were compared in patients who underwent OLT with AF and those without. Among 45,357 patients who underwent OLT, women made up 35.8 % of the overall population. The prevalence of AF prior to transplant was 2932 (6.5%) with a trend towards increasing prevalence, with an annual change rate of 4.19%. Applying propensity score matching to control for potential confounding factors, there was no association between pre-transplant AF and in-hospital mortality in patients undergoing OLT, however, there was a higher incidence of perioperative complications. Older age, the presence of heart failure, and anemia were independently predictive of higher mortality in patients with pre-transplant AF undergoing OLT. In patients undergoing OLT, pre-transplant AF is increasing in prevalence and appears to be associated with similar in-hospital mortality but worse perioperative outcomes. Greater emphasis should be placed on AF in the preoperative cardiovascular risk stratification of patients undergoing OLT.
Dec 2022Published in Journal of Cardiac Surgery volume 37 issue 12 on pages 4762-4773. 10.1111/jocs.17183